Basic Information
| Provider Information | |||||||||
| NPI: | 1508980020 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOYEN | ||||||||
| FirstName: | JEAN | ||||||||
| MiddleName: | NATALIE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | NURSE PRACTITIONER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 430 S MAPLE AVE | ||||||||
| Address2: | |||||||||
| City: | BASKING RIDGE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079201326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089530103 | ||||||||
| FaxNumber: | 9089538103 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 KNOLLCROFT RD | ||||||||
| Address2: | |||||||||
| City: | LYONS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079395001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9086470180 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 26NN05377300 | NJ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.