Provider Demographics
NPI:1851560783
Name:ETIENNE, SABINE THEVENIN (CRNA)
Entity Type:Individual
Prefix:
First Name:SABINE
Middle Name:THEVENIN
Last Name:ETIENNE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 720188
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-0188
Mailing Address - Country:US
Mailing Address - Phone:956-664-9771
Mailing Address - Fax:956-664-9773
Practice Address - Street 1:2010 S CYNTHIA ST STE 101
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1387
Practice Address - Country:US
Practice Address - Phone:956-664-9771
Practice Address - Fax:956-664-9773
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114715367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered