Healthcare Provider Details
I. General information
NPI: 1669676888
Provider Name (Legal Business Name): CAROL ELIZABETH DOYLE R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
747 CAMBRIDGE ST
BRIGHTON MA
02135-2926
US
IV. Provider business mailing address
46 KEYES DR
PEABODY MA
01960-8004
US
V. Phone/Fax
- Phone: 800-833-1220
- Fax: 617-782-0255
- Phone: 800-833-1220
- Fax: 866-932-1118
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WH0500X |
| Taxonomy | Hemodialysis Registered Nurse |
| License Number | 201160 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: