Breezetta Lowanet Etienne, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PAC0333 Issued in ND

Practice address

1599 J St
Grand Forks AFB, ND 58205-6306

Phone

(701) 747-6687

NPI assigned

Oct 25, 2005

Last updated

Jul 13, 2026By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659361244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 10TH ST SE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567212252",
            "telephone_number": "218-773-1492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1599 J ST",
            "city": "GRAND FORKS AFB",
            "state": "ND",
            "postal_code": "582056306",
            "telephone_number": "701-747-6687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "BREEZETTA",
        "middle_name": "LOWANET",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ND",
            "license": "PAC0333",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MN",
            "license": "815",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole J Chine, PT
• Johnathan Mark Compton, M.D.
• Marie Elyse Corbin, LCSW
• Dennise Cortes, MD
• Linda M Dunnigan, RN
• Benjamin Scott Fenger, D.D.S.
• Christopher Edward Franken, IDMT
• Dustin Frize
• Howard R Givens, M.D.
• Laine Maren Gordon, LCSW

• Medical Physician Assistant in Grand Forks AFB, ND
• Providers in Grand Forks AFB, ND by specialty
• Medical Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.