Individual provider Active NPI

Linouse Etienne

  • Family Nurse Practitioner
  • Lakeland, FL
National Provider Identifier
1861081051
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F12200637 Issued in FL
Practice address
1129 N Missouri Ave
Lakeland, FL 33805-4411
Phone
(866) 234-8534
NPI assigned
Jan 13, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F12200637 FL Primary

Addresses

Primary practice location

1129 N Missouri Ave
Lakeland, FL 33805-4411

Mailing address

47 5TH St NW
Winter Haven, FL 33881-4672
Phone (866) 234-8534

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240604001382 FL Practitioner - Nurse Practitioner 9739621988 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F12200637FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Central Florida Health Care, Inc CurrentSince May 22, 2024 Accepting new patients
Central Florida Health Care, Inc. CurrentSince May 22, 2024 Accepting new patients
Central Florida Health Care, Inc. Current Accepting new patients

Locations

950 County Road 17A W
Avon Park, FL 33825
Phone (863) 452-3000

109 W Wall St
Frostproof, FL 33843
Phone (863) 635-4891

305 W Central Ave
Fl Heal
Lake Wales, FL 33853

1129 N Missouri Ave
Lakeland, FL 33805
Phone (863) 413-8600

601 S Florida Ave
Ste 6
Lakeland, FL 33801
Phone (863) 688-0841

47 5th St NW
Winter Haven, FL 33881

Interoperability endpoints

  • Direct secure messaging: linouse.etienne@316.emedpractice.direct-ci.com

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": "1610496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1861081051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 5TH ST NW",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338814672",
            "telephone_number": "866-234-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 N MISSOURI AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338054411",
            "telephone_number": "866-234-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "LINOUSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-13",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F12200637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.