Healthcare Provider Details

I. General information

NPI: 1922632892
Provider Name (Legal Business Name): AMANDA SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2020
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 CLIFTY ST
SOMERSET KY
42503-1765
US

IV. Provider business mailing address

PO BOX 628
NANCY KY
42544-0628
US

V. Phone/Fax

Practice location:
  • Phone: 606-485-4730
  • Fax:
Mailing address:
  • Phone: 606-288-0013
  • Fax: 606-288-9600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3018169
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018169
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: