Individual provider Active NPI

Julouse Etienne, ARNP

  • General Practice Registered Nurse
  • Fort Pierce, FL
National Provider Identifier
1669947164
Registry record updated Oct 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
9344569 Issued in FL
Practice address
1700 S 23Rd St
Fort Pierce, FL 34950-4899
Phone
(772) 461-4000
NPI assigned
Oct 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 9344569 FL Primary

Addresses

Primary practice location

1700 S 23Rd St
Fort Pierce, FL 34950-4899

Mailing address

5574 55TH Ave
Vero Beach, FL 32967-2460
Phone (954) 592-6977

Other names 1

  • Julouse Etienne Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DC, VA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20191211002031 FL Practitioner - Nurse Practitioner 7810320520 Reassigns benefits to 1 organization
I20220901000094 DC Practitioner - Nurse Practitioner 7810320520 Reassigns benefits to 1 organization
I20230605003366 VA Practitioner - Nurse Practitioner 7810320520 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thriveworks Clinical - Florida IncGroup PAC ID 5496173577, 85 clinicians

Practice addresses (Care Compare)

4243 Sunbeam Rd
Suite 1
Jacksonville, FL 32257-8975
Phone (904) 507-6712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9344569FLMDGeneral Practice Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Aug 16, 2022 Accepting new patients
Oahu Home Care LLC PastSince May 21, 2019 Accepting new patients

Locations

4243 Sunbeam Rd
Ste 6
Jacksonville, FL 32257
Phone (904) 299-0184

6076 Franconia Rd
Ste D
Alexandria, VA 22310
Phone (703) 828-9054

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

1901 E Franklin St
Ste 108
Richmond, VA 23223
Phone (804) 331-2570

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

2501 Hunter Pl
Ste 202
Woodbridge, VA 22192
Phone (304) 940-9724

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1539129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539129600000",
    "number": "1669947164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5574 55TH AVE",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329672460",
            "telephone_number": "954-592-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 S 23RD ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504899",
            "telephone_number": "772-461-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "JULOUSE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-10",
        "last_updated": "2018-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "9344569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULOUSE",
            "last_name": "ETIENNE",
            "credential": "ARNP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Pierce, FL

Sources for this page

Verify at the official NPI Registry.