Individual provider Active NPI

Edwina Etienne, ARNP

  • Family Nurse Practitioner
  • North Miami Beach, FL
National Provider Identifier
1366628968
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9184071 Issued in FL
Practice address
160 NW 170TH St
North Miami Beach, FL 33169
Phone
(305) 333-2825
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9184071 FL Primary

Addresses

Primary practice location

160 NW 170TH St
North Miami Beach, FL 33169

Mailing address

160 NW 170TH St
North Miami Beach, FL 33169-5521
Phone (305) 333-2825

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

LicenseStateTypeSpecialty
ARNP9184071FLMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1366628968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 NW 170TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "331695521",
            "telephone_number": "305-333-2825",
            "fax_number": "954-436-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 NW 170TH ST",
            "city": "NORTH MIAMI BEACH",
            "state": "FL",
            "postal_code": "33169",
            "telephone_number": "305-333-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "EDWINA",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9184071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.