Healthcare Provider Details

I. General information

NPI: 1306488978
Provider Name (Legal Business Name): JANA SUZANNE DOYLE AGPCNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 MAIN ST STE 210
LAFAYETTE IN
47901-1941
US

IV. Provider business mailing address

427 MAIN ST STE 210
LAFAYETTE IN
47901-1941
US

V. Phone/Fax

Practice location:
  • Phone: 765-413-2831
  • Fax:
Mailing address:
  • Phone: 765-413-2831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28220230A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number71010367A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: