Provider Demographics
NPI:1447033360
Name:SULLIVAN, AMY DOYLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:DOYLE
Last Name:SULLIVAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2004 HIGHWAY 47 N
Mailing Address - Street 2:
Mailing Address - City:WHITE BLUFF
Mailing Address - State:TN
Mailing Address - Zip Code:37187-4100
Mailing Address - Country:US
Mailing Address - Phone:615-908-3680
Mailing Address - Fax:615-908-3679
Practice Address - Street 1:2004 HIGHWAY 47 N
Practice Address - Street 2:
Practice Address - City:WHITE BLUFF
Practice Address - State:TN
Practice Address - Zip Code:37187-4100
Practice Address - Country:US
Practice Address - Phone:615-908-3680
Practice Address - Fax:615-908-3679
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN211737163WE0003X
TN35913363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency