Cheryl-Ann S Ettienne, ED.D, MS, AGPCNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

F306969-1 Issued in NY

Practice address

440 Lenox Rd Apt 5K
Brooklyn, NY 11203-2045

Phone

(718) 926-7934

NPI assigned

Aug 9, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24009/brand/1/csg/1/fhir/r4

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.

• Aspire Health Medical Partners of Middle Tennessee PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Nashville, TN
  • NPI 1215372354
  NPD (past)

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

{
    "created_epoch": "1439078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1649656992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 LENOX RD APT 5K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032045",
            "telephone_number": "718-926-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 LENOX RD APT 5K",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032045",
            "telephone_number": "718-926-7934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16707 29th Ave Apt 1",
            "address_purpose": "LOCATION",
            "city": "Flushing",
            "state": "NY",
            "postal_code": "113581501",
            "country_code": "US",
            "telephone_number": "718-353-6283",
            "fax_number": "718-353-0173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ETTIENNE",
        "first_name": "CHERYL-ANN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "ED.D, MS, AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-09",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F306969-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dean J Etri, D.C.
• Kaili Ets, BHSC., MSC.OT
• Etta Novick MD & Isaac M Novick MD PC
• Etta Novick MD & Isaac M Novick MD PC
• Alana M Ettienne Steele
• Gail Ettienne, MD
• David Jay Ettinger, DPT
• Gitty Ettinger
• Michael Neal Ettinger, DDS
• Reva Leah Ettinger

• Adult Health Nurse Practitioner in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.