Provider Demographics
NPI:1477309235
Name:ETIENNE, MICHELE-ANGE (RN)
Entity type:Individual
Prefix:MRS
First Name:MICHELE-ANGE
Middle Name:
Last Name:ETIENNE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 LUCERNE WAY
Mailing Address - Street 2:
Mailing Address - City:MIRAMAR
Mailing Address - State:FL
Mailing Address - Zip Code:33025-4250
Mailing Address - Country:US
Mailing Address - Phone:786-619-4337
Mailing Address - Fax:
Practice Address - Street 1:3261 LUCERNE WAY
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-4250
Practice Address - Country:US
Practice Address - Phone:786-619-4337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9345368163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse