| Doctor Name: | STEVEN ETIENNE |
| NPI Number: | 1932543659 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | IDMT |
| License Number: | RN225389 |
| Business Practice Address: | 3278 Mitchell Blvd Moody Afb, GA - 316991500 |
| Business Phone Number: | 2292574466 |
| Business Fax Number: | |
| Mailing Address: | 3278 Mitchell Blvd, MOODY AFB |
| State: | GA |
| Postal Code: | 316991500 |
| Phone Number: | 2292574466 |
| Fax Number: | |
| NPI Enumeration Date: | 04/24/2013 |
| NPI Last Update Date: | 04/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WM0705X |
| License Number: | RN225389 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Medical-Surgical |
| Taxonomy Definition: | |