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DR. MIRIAM ETIENNE DNP, FNP-BC
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1336761378
Individual Registrant:DR. MIRIAM ETIENNE DNP, FNP-BC
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
1021 REDDY FARM RD GRAYSON, GA 30017-1754 US
Tel: 347-628-0147 Fax: --
Tel: 347-628-0147 Fax: --
Contact information for business:
1021 REDDY FARM RD GRAYSON, GA 30017-1754 US
Tel: 347-628-0147 Fax: --
Tel: 347-628-0147 Fax: --
Registration Information:
NPI: 1336761378
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | GA | 2019055030 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
