Provider Demographics
NPI:1033465430
Name:ETLING, WILLIAM JAMIN (RN-PARAMEDIC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMIN
Last Name:ETLING
Suffix:
Gender:M
Credentials:RN-PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-7457
Mailing Address - Country:US
Mailing Address - Phone:931-320-9472
Mailing Address - Fax:
Practice Address - Street 1:1900 RIVER RD
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-7457
Practice Address - Country:US
Practice Address - Phone:931-320-9472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31115146L00000X
TN175440163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic