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NPI Code Detail

MEDICARE: MRS. AUDRA LISA DOYLE NP-C

MEDICARE: MRS. AUDRA LISA DOYLE NP-C
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
1363LP2300XPrimary Care Nurse Practitioner0024172315VA
2363LA2200XAdult Health Nurse Practitioner0024172315VA

General Provider Information

NPI Number : 1417347451
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AUDRA LISA DOYLE NP-C
Provider Business Mailing Address
First Line : 249 CENTRAL PARK AVE STE 300
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-3271
Country : US
Telephone Number : 650-761-4737
Fax Number : 877-395-9003
Provider Business Practice Location Address
First Line : 249 CENTRAL PARK AVE STE 300
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-3271
Country : US
Telephone Number : 650-761-4737
Fax Number : 877-395-9003
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2015
Last Update Date : 01/18/2024

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