STEVEN ETIENNE (NPI# 1932543659) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1932543659 |
Entity Type | Individual |
Full Name | STEVEN ETIENNE |
Credential | IDMT |
Practice Address |
3278 Mitchell Blvd Moody Afb GA 31699-1500 |
Practice Telephone | 2292574466 |
Mailing Telephone | 2292574466 |
Enumeration Date | 2013-04-24 |
Last Update Date | 2013-04-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 146M00000X | Emergency Medical Technician, Intermediate | E3054072 | GA | Emergency Medical Service Providers |
N | 163WM0705X |
Registered Nurse Specialization: Medical-Surgical |
RN225389 | GA | Nursing Service Providers |
Street Address |
3278 MITCHELL BLVD |
City | MOODY AFB |
State | GA |
Zip Code | 31699-1500 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811982903 | Yvette Guzman | Pediatrics | 3278 Mitchell Blvd, Moody Afb, Moody Afb, GA 31699-1500 | 2005-09-14 |
1578179958 | Lawanna Renee Barron | Social Worker | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2020-09-21 |
1831725381 | Bradley James Connahey | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2020-03-17 |
1477049781 | Andrew Glidewell | Physician Assistant | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2018-07-10 |
1215431309 | Taylor Montana Martin | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2018-03-22 |
1982120796 | Byron Reed | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2017-08-15 |
1568909091 | Bailey Holt | Military Health Care Provider | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2017-01-23 |
1770941254 | Ashley Patterson | Contractor | 3278 Mitchell Blvd, Building 900, Moody Afb, GA 31699-1500 | 2016-01-29 |
1982088340 | Sarah E Stone | Nurse Practitioner | 3278 Mitchell Blvd, Moody Afb, GA 31699-5529 | 2015-07-16 |
1427439165 | Armand Allkanjari | General Practice | 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2015-06-17 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548771876 | Aldo Enrique Revilla | Psychologist | Bermiss Rd, Moody Afb, Valdosta, GA 31699 | 2017-10-13 |
1699903146 | Elizabeth L Fauber | Military Health Care Provider | 9551 Luke Street, Apo, AP 31699 | 2009-06-23 |
1063646230 | James Michael White | Military Health Care Provider | 3278 Mithell Blvd, Bldg. 900, Moody Afb, GA 31699 | 2009-05-04 |
1265415590 | Rosalie Andrea Castillo | Family Medicine | 347th Medical Group, 3278 Mitchell Blvd, Valdosta, GA 31699 | 2005-11-21 |
1902379555 | Amber Leigh Tordoff | Student in an Organized Health Care Education/Training Program | 23d Medical Group 3278 Mitchell Blvd, Building 900, Apo, AA 31699 | 2019-01-07 |
1083147367 | Jordan Robbins | Dentist | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699 | 2017-04-04 |
1518364678 | Rachel Collins | Specialist/Technologist | 23 Mdos Sgoy, 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2014-12-04 |
1083988356 | Brock Allen Mcnabb | Social Worker | 23rd Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699-0001 | 2012-03-02 |
1760711162 | Christopher Wayne Daniels | Physician Assistant | 23 Medical Group, 3278 Mitchell Blvd, Moody A F B, GA 31699-0001 | 2009-12-14 |
1447487749 | Roong Robert Burket | Military Health Care Provider | 347 Oss Osm, Moody A F B, GA 31699-0001 | 2009-06-15 |
Find all providers in zip 31699 |
Taxonomy Code | 146M00000X |
Grouping | Emergency Medical Service Providers |
Classification | Emergency Medical Technician, Intermediate |
An Intermediate EMT is an individual trained and certified to perform intermediate life support treatment in medical emergencies based on individual state boards. |
Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346850856 | Christopher Lee Bailey | Emergency Medical Technician, Intermediate | 1893 Lathrop St Se, Atlanta, GA 30315-6917 | 2020-08-10 |
1881214872 | Roger Lee Jackson II | Emergency Medical Technician, Intermediate | 713 Clifton Rd Se, Atlanta, GA 30316-2229 | 2020-04-20 |
1487210704 | Andre Grant | Emergency Medical Technician, Intermediate | 2136 W Park Ct Ste B, Stone Mountain, GA 30087-3528 | 2019-05-13 |
1760944334 | Arelious Dunn | Emergency Medical Technician, Intermediate | 6722 Highway 85 Ste 5, Riverdale, GA 30274-2373 | 2019-04-03 |
1811488836 | Jeffrey Touchberry | Emergency Medical Technician, Intermediate | 217 Lovebridge Dr Se, Calhoun, GA 30701-4800 | 2018-05-24 |
1750800058 | Shawn Anthony Moore | Emergency Medical Technician, Intermediate | 900 N Hairston Rd Ste A3, Stone Mountain, GA 30083-2857 | 2017-09-18 |
1689101479 | Pamela Olivia Dugar | Emergency Medical Technician, Intermediate | 3117 Deans Bridge Rd, Augusta, GA 30906-3379 | 2017-05-11 |
1457890824 | James Richard Dow II | Emergency Medical Technician, Intermediate | 1453 Wood Park Way Nw, Kennesaw, GA 30152-4670 | 2017-02-18 |
1023566387 | Kalli Pelar Coleman Addison | Emergency Medical Technician, Intermediate | 131 Cypress Ln, Eatonton, GA 31024-7567 | 2016-09-15 |
1437567385 | Anthony Quinn Hodge | Emergency Medical Technician, Intermediate | 4035 Jonesboro Rd Ste 240, Forest Park, GA 30297-1035 | 2014-07-23 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.