Provider Demographics
NPI:1861255812
Name:DOYLE, CARTER PHILIP (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:CARTER
Middle Name:PHILIP
Last Name:DOYLE
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6549 TOWN CENTER DR STE A
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-4824
Mailing Address - Country:US
Mailing Address - Phone:800-395-3223
Mailing Address - Fax:734-228-0593
Practice Address - Street 1:450 S MAPLE RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-3835
Practice Address - Country:US
Practice Address - Phone:734-210-1710
Practice Address - Fax:734-228-0593
Is Sole Proprietor?:No
Enumeration Date:2024-02-02
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4472-0363LP0808X
AZ305584363LP0808X
MI4704343820363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health