Alexander Etu

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

RN215721 Issued in AZ

Practice address

3207 S 73Rd Dr
Phoenix, AZ 85043-7230

Phone

(623) 238-9777

NPI assigned

Dec 5, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1638662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638662400000",
    "number": "1972261196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W WESTERN AVE UNIT 345",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853234414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3207 S 73RD DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850437230",
            "telephone_number": "623-238-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETU",
        "first_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-05",
        "last_updated": "2021-12-05",
        "certification_date": "2021-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "AZ",
            "license": "RN215721",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "AZ",
            "license": "RN215721",
            "primary": false
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "AZ",
            "license": "RN215721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Valerie Etienne, MD
• Samuel Lucas Etling
• Ali Etman
• Saslee Etrata-Daite
• Kristal Rayne Etsitty
• Akaninyene Etukudoh, PMHNP
• Aniema James Etukudoh
• David A Etzioni, MD
• Michael M Etzl Jr., M.D.
• Samantha Eubel, RD, LD

• General Practice Registered Nurse in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.