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NPI Code Detail

MEDICARE: KATLEEN THERMEZY ETIENNE ARNP

MEDICARE: KATLEEN THERMEZY ETIENNE ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN9339484FL
2363LF0000XFamily Nurse Practitioner9339484FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568891877
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATLEEN THERMEZY ETIENNE ARNP
Provider Business Mailing Address
First Line : 10300 SW 216TH ST
Second Line :
City : CUTLER BAY
State : FL
Zip : 33190-1003
Country : US
Telephone Number : 305-253-5100
Fax Number :
Provider Business Practice Location Address
First Line : 10300 SW 216TH ST
Second Line :
City : CUTLER BAY
State : FL
Zip : 33190-1003
Country : US
Telephone Number : 305-253-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2013
Last Update Date : 06/09/2026

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Directions to “ KATLEEN THERMEZY ETIENNE ARNP” Practice Location

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