Healthcare Provider Details

I. General information

NPI: 1427215268
Provider Name (Legal Business Name): TIFFANY ANN DOYLE APN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIFFANY ANN BENFIELD APN

II. Dates (important events)

Enumeration Date: 05/20/2008
Last Update Date: 01/04/2022
Certification Date: 01/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 LANDFALL WAY BTE B
SEABROOK ISLAND SC
29455
US

IV. Provider business mailing address

PO BOX 602108
CHARLOTTE NC
28260-2108
US

V. Phone/Fax

Practice location:
  • Phone: 843-768-0888
  • Fax:
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number24780
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209-004621
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: