Jansie Etienne, ARNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

9245185 Issued in FL

Practice address

1170 NW 149TH Ter
Miami, FL 33168-2025

Phone

(305) 824-7020

NPI assigned

May 8, 2018

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1821587502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 NW 149TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331682025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 NW 149TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331682025",
            "telephone_number": "305-824-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "JANSIE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "9245185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1821587502",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "MIAMI",
            "affiliation": "N",
            "endpointDescription": "optional",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "optional",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "MIAMI",
            "address_1": "6400 nw 2nd ave",
            "city": "MIAMI",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33168",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ethereal Medspa LLC
• Ethos Behavioral Therapy LLC
• Ethan Etiel
• Yosef Etiel
• Jackson Etienne
• Kanson Etienne
• Pascale Lamothe Etienne
• Santcha Etienne
• Sherley Etienne
• Tamara Esther Etienne

• Women's Health Nurse Practitioner in Miami, FL
• Providers in Miami, FL by specialty
• Women's Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2020; 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.