Individual
SAMANTHA ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
22395 EDGEWATER DR, PORT CHARLOTTE, FL 33980-2012
(941) 766-7222
Mailing address
4371 VERONICA S SHOEMAKER BLVD, FORT MYERS, FL 33916-2216
(239) 274-8200
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
APRN11001281
FL
Other
Enumeration date
11/04/2019
Last updated
11/04/2019
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