Healthcare Provider Details

I. General information

NPI: 1215551122
Provider Name (Legal Business Name): ALDENE DOYLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 03/10/2021
Certification Date: 03/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9135 PISCATAWAY RD STE 420
CLINTON MD
20735-2555
US

IV. Provider business mailing address

100 HOSPITAL RD
PRINCE FREDERICK MD
20678-4017
US

V. Phone/Fax

Practice location:
  • Phone: 301-868-2555
  • Fax:
Mailing address:
  • Phone: 410-414-4791
  • Fax: 410-414-4556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1012447
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR176108
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: