MEDICARE: MRS. MARY JANE DOYLE APRN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	3005493	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114075835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY JANE DOYLE APRN

Provider Business Mailing Address
First Line	:	2620 ELM HILL PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37214-3108
Country	:	US
Telephone Number	:	615-425-4200
Fax Number	:	615-891-5244

Provider Business Practice Location Address
First Line	:	3101 RICHMOND RD
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1599
Country	:	US
Telephone Number	:	859-268-9866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	05/21/2021

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