Active NPI
Daphne Etienne
- Family Nurse Practitioner
- Severna Park, MD
National Provider Identifier
1508216276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R190278
- Practice address
- 25 Jones Station Rd W
Severna Park, MD 21146-4200 - Phone
- (410) 647-0451
- NPI assigned
- Jun 14, 2016
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R190278 | MD | Primary |
Addresses
Primary practice location
25 Jones Station Rd W
Severna Park, MD 21146-4200
Mailing address
56 Joyceton Way
Upper Marlboro, MD 20774-1400
Phone (301) 535-7520
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": "1465862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1508216276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 JOYCETON WAY",
"city": "UPPER MARLBORO",
"state": "MD",
"postal_code": "207741400",
"telephone_number": "301-535-7520"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 JONES STATION RD W",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464200",
"telephone_number": "410-647-0451"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETIENNE",
"first_name": "DAPHNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-06-14",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MD",
"license": "R190278",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.