Physician Compare National (NPI:1396138368)

HEALTHCARE PROVIDER: JOSETTE ETIENNE FNP-C

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1396138368
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8527348929
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161130001770
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ETIENNE
	Individual professional last name
Provider First Name	JOSETTE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2015
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	403 PERMIAN WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A
	Group Practice or individual's line 2 address
City	VILLA RICA
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	301803226
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y