Healthcare Provider Details

I. General information

NPI: 1922775006
Provider Name (Legal Business Name): VIRGINIA KATHERINE SEXTON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 JACKSBORO PIKE
JACKSBORO TN
37757-4850
US

IV. Provider business mailing address

4709 DEVON SPRINGS WAY APT 2209
KNOXVILLE TN
37918-4572
US

V. Phone/Fax

Practice location:
  • Phone: 423-201-9937
  • Fax:
Mailing address:
  • Phone: 423-278-6478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number30003
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: