Provider Demographics
NPI:1871100354
Name:DOYLE, KRISTIN MARY (APRN)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MARY
Last Name:DOYLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:KRISTIN
Other - Middle Name:MARY
Other - Last Name:DUB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:5010 BUTTONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-3006
Mailing Address - Country:US
Mailing Address - Phone:727-215-3815
Mailing Address - Fax:
Practice Address - Street 1:1807 3RD ST N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-7491
Practice Address - Country:US
Practice Address - Phone:904-400-7772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11008024363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily