Individual provider · Type 1 NPI

Samantha Etienne, APRN

Gerontology Nurse Practitioner · Port Charlotte, FL

NPI number 1801430780 Active

Practice location

22395 Edgewater Dr
Port Charlotte, FL 33980-2012

Mailing address

4371 Veronica S Shoemaker Blvd
Fort Myers, FL 33916-2216

Specialties and licenses

TaxonomyCodeLicense
Gerontology Nurse Practitioner Primary 363LG0600XAPRN11001281 (FL)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1801430780

Samantha Etienne, APRN's National Provider Identifier is 1801430780, issued on Nov 4, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Port Charlotte, FL. The record was last updated on Nov 4, 2019.