Idania Lissette Ettienne, ARNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

ARNP9211883 Issued in FL

Practice address

907 N Parsons Ave
Brandon, FL 33510-3107

Phone

(813) 689-8020

Fax

(813) 689-8381

NPI assigned

Dec 30, 2014

Last updated

Aug 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• Inpatient Specialists Group

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1073008579
  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• Inpatient Specialists Group

  dba Continuity Care Speciliasts

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1952108763
  NPD
• Silver Wings Independence at Home LLC

  • Geriatric Medicine (Family Medicine) Physician
  • Pinellas Park, FL
  • NPI 1407128234
  NPD (past)

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

{
    "created_epoch": "1419897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1518355478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 BLOOMFIELD GROVE PL",
            "city": "SEFFNER",
            "state": "FL",
            "postal_code": "335842522",
            "telephone_number": "813-418-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 N PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335103107",
            "telephone_number": "813-689-8020",
            "fax_number": "813-689-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTIENNE",
        "first_name": "IDANIA",
        "middle_name": "LISSETTE",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-30",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9211883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "015021300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gislaine Etienne
• Nicolas Etienne
• Ronney Etienne, PT
• Shanelle Etienne, D.C
• David Etter, MD
• Nicole Eugenio
• Astrid Amparo Eure
• James Dennis Evans III, LMHC
• Sarah Evers, RBT
• Evolution Counseling Associates

• Family Nurse Practitioner in Brandon, FL
• Providers in Brandon, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.