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NPI Code Detail

MEDICARE: NICANOR ETIENNE

MEDICARE: NICANOR ETIENNE
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
1343900000XNon-emergency Medical Transport (VAN)

General Provider Information

NPI Number : 1669300281
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICANOR ETIENNE
Provider Business Mailing Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 980-380-6757
Fax Number :
Provider Business Practice Location Address
First Line : 4030 WAKE FOREST RD STE 349
Second Line :
City : RALEIGH
State : NC
Zip : 27609-0010
Country : US
Telephone Number : 980-380-6757
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2026
Last Update Date : 05/12/2026

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Directions to “ NICANOR ETIENNE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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