Individual
JANSIE ETIENNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1170 NW 149TH TER, MIAMI, FL 33168-2025
(305) 824-7020
Mailing address
1170 NW 149TH TER, MIAMI, FL 33168-2025
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
9245185
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821587502
—
FL
Enumeration date
05/08/2018
Last updated
10/15/2020
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