Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gregory Etienne, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1669180915

Gregory Etienne, PHYSICIANASSISTANT is a Physician Assistant in Sierra Vista, Arizona. Qualified in 2016, 10 years ago. Practices with Keyamed, Inc a P C, a 2-clinician group and accepts Medicare assignment. Licensed in Arizona and Puerto Rico.

Years since qualifying
10
Licensed in
AZ, PR
In the registry since
2022
Specialties on file
2

Practice location Address checks out

126 S Coronado Dr Ste B
Sierra Vista, AZ 85635-6300
Phone: (786) 618-8554
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10192 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 1447 (PR)

Record details

NPI number1669180915
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedNovember 7, 2022
Last updated in NPPESJune 4, 2024
Certification dateJune 4, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Keyamed, Inc A P C — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Sierra Vista