Individual
JESSICA M ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
345 N HARRIS ST, ATHENS, GA 30601-2411
(706) 389-6921
Mailing address
PO BOX 1150, MONROE, GA 30655-1150
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN297806
GA
363LF0000X
Family Nurse Practitioner
RN297806
GA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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