Individual provider · Type 1 NPI
Javan Ettiene
Psychiatric/Mental Health Nurse Practitioner · Miramar, FL
NPI number
1174197164
Active
Practice location
7904 Lasalle Blvd
Miramar, FL 33023-4500
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | APRN11013397 (FL) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1174197164
Javan Ettiene's National Provider Identifier is 1174197164, issued on May 14, 2021. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Miramar, FL. The record was last updated on Jun 11, 2021.