Active NPI
Rochelle Thilly Etienne, PA-C
- Physician Assistant
- Baltimore, MD
National Provider Identifier
1134031271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- C0010775
- Practice address
- 3804 Mayberry Ave
Baltimore, MD 21206-1701 - Phone
- (301) 233-8239
- NPI assigned
- Sep 22, 2026
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | C0010775 | MD | Primary |
Addresses
Primary practice location
3804 Mayberry Ave
Baltimore, MD 21206-1701
Mailing address
3804 Mayberry Ave
Baltimore, MD 21206-1701
Phone (301) 233-8239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790035200000",
"number": "1134031271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3804 MAYBERRY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212061701",
"telephone_number": "301-233-8239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3804 MAYBERRY AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212061701",
"telephone_number": "301-233-8239"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "ROCHELLE",
"middle_name": "THILLY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-09-22",
"last_updated": "2026-09-22",
"certification_date": "2026-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MD",
"license": "C0010775",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.