Etyane Ayana

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F12220253 Issued in MN

Practice address

17305 Cedar Ave S Ste 220
Lakeville, MN 55044-3903

Phone

(952) 465-1959

Fax

(952) 236-0138

NPI assigned

Jun 30, 2008

Last updated

Jan 17, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in MN

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Doctor Etyane Ayana

  dba Trinity Health Community Clinic

  • Primary Care Nurse Practitioner
  • Burnsville, MN
  • NPI 1043182801
  Medicare reassignment NPD Authorized official
• Trinityhome Healthcare Services Inc

  • Home Health Agency
  • Burnsville, MN
  • NPI 1821248519
  NPD Authorized official

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1972765972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20787 GEMINI TRL",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550442515",
            "telephone_number": "952-217-3635",
            "fax_number": "952-236-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17305 CEDAR AVE S STE 220",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550443903",
            "telephone_number": "952-465-1959",
            "fax_number": "952-236-0138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYANA",
        "first_name": "ETYANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "F12220253",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "R178274-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Gerard Arnold, D.D.S.
• Arya Global Services LLC (CFSS Pca)
• Assist at Home Corporation
• Trisha Lee Augustine, D.C.
• Ashley Anne Aurich, DPT
• Back to Health Chiropractic Center, P.a.
• Connie Marie Backstrom, LMFT
• Steven A Bacon, BS
• Haylee Baier
• Kimberly Ann Bakken, RN

• Family Nurse Practitioner in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.