Healthcare Provider Details

I. General information

NPI: 1710105598
Provider Name (Legal Business Name): JOHN CARROLL SEXTON FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 OLD HAYWOOD RD
ASHEVILLE NC
28806-1154
US

IV. Provider business mailing address

1710 OLD HAYWOOD RD
ASHEVILLE NC
28806-1154
US

V. Phone/Fax

Practice location:
  • Phone: 828-285-9725
  • Fax: 828-285-9672
Mailing address:
  • Phone: 828-285-9725
  • Fax: 828-285-9672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number110418
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: