Breezetta Lowanet Etienne, PA-C is a
Physician Assistant - Medical based in Grand Forks Afb, North Dakota. Breezetta Lowanet Etienne is licensed to practice in North Dakota (license number PAC0333) and her current practice location is
1599 J St, Grand Forks Afb, North Dakota. She can be reached at her office (for appointments etc.) via phone at
(701) 747-6687.
NPI number for Breezetta Lowanet Etienne is 1659361244 and her current mailing address is 1600 10th St Se, East Grand Forks, Minnesota. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1659361244.
Provider's Profile
| Full Name | Breezetta Lowanet Etienne |
|---|
| Gender | Female |
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| Speciality | Physician Assistant - Medical |
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| Location | 1599 J St, Grand Forks Afb, North Dakota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1659361244
- Provider Enumeration Date: 10/25/2005
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Breezetta Lowanet Etienne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1659361244 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | PAC0333 (North Dakota) | Primary |
| 363AM0700X | Physician Assistant - Medical | 815 (Minnesota) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Breezetta Lowanet Etienne is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Breezetta Lowanet Etienne, PA-C
1600 10th St Se,
East Grand Forks, MN 56721-2252
Ph: (218) 773-1492 | Breezetta Lowanet Etienne, PA-C
1599 J St,
Grand Forks Afb, ND 58205-6306
Ph: (701) 747-6687 |
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