Active NPI
Luann Etcher, N.P.
- Nurse Practitioner
- Independence, OH
National Provider Identifier
1043308398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 4704155261
- Practice address
- 6150 Oak Tree Blvd
Suite 200
Independence, OH 44131-6917 - Phone
- (800) 897-9177
- Fax
- (800) 470-8713
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 4704155261 | MI | Primary |
Addresses
Primary practice location
6150 Oak Tree Blvd
Suite 200
Independence, OH 44131-6917
Mailing address
6149 N Wayne Rd
Westland, MI 48185-7128
Phone (734) 728-2130
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4583018 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445904000000",
"number": "1043308398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6149 N WAYNE RD",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481857128",
"telephone_number": "734-728-2130",
"fax_number": "734-728-2626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6150 OAK TREE BLVD",
"address_2": "SUITE 200",
"city": "INDEPENDENCE",
"state": "OH",
"postal_code": "441316917",
"telephone_number": "800-897-9177",
"fax_number": "800-470-8713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETCHER",
"first_name": "LUANN",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2015-10-27",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MI",
"license": "4704155261",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4583018",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Independence, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.