Provider Demographics
NPI:1174774061
Name:DOYLE, ELLEN D (APN,PMHNP-C,FNP-C)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:D
Last Name:DOYLE
Suffix:
Gender:F
Credentials:APN,PMHNP-C,FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 S NEW RD UNIT 9
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08232-3728
Mailing Address - Country:US
Mailing Address - Phone:609-200-5117
Mailing Address - Fax:609-939-3671
Practice Address - Street 1:1420 S NEW RD UNIT 9
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08232-3728
Practice Address - Country:US
Practice Address - Phone:609-200-5117
Practice Address - Fax:609-939-3671
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00707600363LF0000X, 363LP0808X
PASP00425B363LF0000X
PASP004252B363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily