Healthcare Provider Details

I. General information

NPI: 1003779612
Provider Name (Legal Business Name): TERY PAUL SEXTON PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9250 W THOMAS RD STE 100
PHOENIX AZ
85037-3383
US

IV. Provider business mailing address

9250 W THOMAS RD STE 100
PHOENIX AZ
85037-3383
US

V. Phone/Fax

Practice location:
  • Phone: 602-610-1191
  • Fax: 602-835-0559
Mailing address:
  • Phone: 602-610-1191
  • Fax: 602-835-0559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number332352
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: