Healthcare Provider Details

I. General information

NPI: 1568640001
Provider Name (Legal Business Name): LOIS BRIDGEWATER DOYLE CNM, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOIS L BRIDGEWATER-SMITH MSN, CNM, FNP-C

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 01/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3140 FLORIDA BLVD
BATON ROUGE LA
70806-3757
US

IV. Provider business mailing address

PO BOX 66156
BATON ROUGE LA
70896-6156
US

V. Phone/Fax

Practice location:
  • Phone: 225-264-6800
  • Fax:
Mailing address:
  • Phone: 225-264-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number85627-5034/ AP05034
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberRN085627
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: