Healthcare Provider Details

I. General information

NPI: 1871647842
Provider Name (Legal Business Name): KERI ANNE SEXTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 03/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 WINTER STREET, SUITE 3800 MA030-1000
WALTHAM MA
02451
US

IV. Provider business mailing address

19 WOOD HILL DR
AUBURN NH
03032-3138
US

V. Phone/Fax

Practice location:
  • Phone: 781-718-5755
  • Fax:
Mailing address:
  • Phone: 603-361-2752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number252158
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: