Healthcare Provider Details

I. General information

NPI: 1144031618
Provider Name (Legal Business Name): MELISSA SEXTON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/15/2025
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

729 FUDGES CREEK RD
BARBOURSVILLE WV
25504-9716
US

IV. Provider business mailing address

33 TOWNSHIP ROAD 1322
PROCTORVILLE OH
45669-8204
US

V. Phone/Fax

Practice location:
  • Phone: 304-972-4546
  • Fax:
Mailing address:
  • Phone: 304-617-3291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number2041393
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: