Healthcare Provider Details

I. General information

NPI: 1669800256
Provider Name (Legal Business Name): LYNN SEXTON CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2013
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2731 MLK JR BLVD
TUSCALOOSA AL
35401-5235
US

IV. Provider business mailing address

2731 MLK JR BLVD
TUSCALOOSA AL
35401-5235
US

V. Phone/Fax

Practice location:
  • Phone: 205-349-3250
  • Fax: 205-752-1517
Mailing address:
  • Phone: 205-349-3250
  • Fax: 205-752-1517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-057340
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: