Healthcare Provider Details
I. General information
NPI: 1720456106
Provider Name (Legal Business Name): LAUREN DOYLE WHNP, APRN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/02/2015
Last Update Date: 06/10/2021
Certification Date: 06/10/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5320 HYLAND GREENS DR
BLOOMINGTON MN
55437-3934
US
IV. Provider business mailing address
8170 33RD AVE S # MS 21110Q
BLOOMINGTON MN
55425-4516
US
V. Phone/Fax
- Phone: 952-993-2400
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | CNP4130 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: