Active NPI
Manuela Etienne Jean
- Adult Companion
- Mooresville, NC
National Provider Identifier
1124859848
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- HC7540
- Practice address
- 710 N Broad St Ste 7
Mooresville, NC 28115-9552 - Phone
- (980) 892-6439
- NPI assigned
- Aug 13, 2024
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | HC7540 | NC | Primary |
Addresses
Primary practice location
710 N Broad St Ste 7
Mooresville, NC 28115-9552
Mailing address
710 N Broad St Ste 7
Mooresville, NC 28115-9552
Phone (980) 892-6439
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HC7540 | NC | MD | Adult Companion |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trusted Home Care Inc | Current | Accepting new patients |
Locations
710 N Broad St
Ste 7
Mooresville, NC 28115
Phone (980) 892-6439
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- In Home Supportive Care Agency
- Mooresville, NC
- NPI 1952133100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1124859848",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 N BROAD ST STE 7",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281159552",
"telephone_number": "980-892-6439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 N BROAD ST STE 7",
"city": "MOORESVILLE",
"state": "NC",
"postal_code": "281159552",
"telephone_number": "980-892-6439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE JEAN",
"first_name": "MANUELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-13",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "NC",
"license": "HC7540",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mooresville, NC
- Empyrean Hospice of Virginia, LLC
- Empyrean Palliative Care, LLC
- Enduring Care Counseling Services PLLC
- Peter Jay Enyeart, M.D.
- Diana Jane Bertelsen Eshleman, AUD
- Eunoia Counseling and Consulting PLLC
- Joy Elizabeth Evans, RN, BSN
- Everflow Behavioral Health, PLLC
- Eyes on Lake Norman Optometry, PA
- F&S Professional Services Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.