Gregory Etienne, PHYSICIAN ASSISTANT
Physician Assistant in Sierra Vista, Arizona
1669180915- Practice location
- 126 S Coronado Dr Ste B, Sierra Vista, AZ 85635-6300
- Phone
- 786-618-8554
- Fax
- —
- Last updated
- June 4, 2024
Gregory Etienne is a Physician Assistant based in Sierra Vista, AZ. Gregory Etienne practices in Sierra Vista, AZ and has the professional credentials of PHYSICIAN ASSISTANT. The NPI Number for Gregory Etienne is 1669180915 and holds a License No. 1447 (PR). The current practice location address for Gregory Etienne is 126 S Coronado Dr Ste B, Sierra Vista, AZ 85635-6300 and can be reached out via phone at 786-618-8554.
Provider Profile Details
- NPI Number
- 1669180915
- Provider Name
- Gregory Etienne
- Credential
- PHYSICIAN ASSISTANT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 126 S Coronado Dr Ste B, Sierra Vista, AZ 85635-6300
- Phone Number
- 786-618-8554
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- Yes
- Other Names
- -- Gregory Etienne (Other Name)
- Provider Enumeration Date
- November 7, 2022
- Last Update Date
- June 4, 2024
- Certification Date
- June 4, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 126 S Coronado Dr Ste B
Sierra Vista, AZ 85635-6300 - City
- Sierra Vista
- State
- Arizona
- Zip
- 85635-6300
- Phone Number
- 786-618-8554
Provider Business Mailing Address Details
- Address
- 8 Joan St
Wilbraham, MA 01095-2035 - City
- Wilbraham
- State
- MA
- Zip
- 01095-2035
- Phone Number
- 786-618-8554
License Information
- License Number (1)
- 1447
- License State (1)
- PR
- Taxonomy (1)
- Physician Assistant · 363A00000X
- License Number (2)
- 10192
- License State (2)
- AZ
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physician Assistants near Sierra Vista, AZ
View all Physician Assistants in Sierra Vista →Frequently Asked Questions
What is the NPI number of Gregory Etienne, PHYSICIAN ASSISTANT?
The NPI number of Gregory Etienne, PHYSICIAN ASSISTANT is 1669180915. It was assigned on November 7, 2022 and is currently active in the NPPES registry.
What is the specialty of Gregory Etienne, PHYSICIAN ASSISTANT?
Gregory Etienne, PHYSICIAN ASSISTANT is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in PR under license number 1447.
Where does Gregory Etienne, PHYSICIAN ASSISTANT practice?
The practice location is 126 S Coronado Dr Ste B, Sierra Vista, AZ 85635-6300. The office can be reached at 786-618-8554 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1669180915 directly on the NPPES registry website.