Healthcare Provider Details

I. General information

NPI: 1275207177
Provider Name (Legal Business Name): AMBER SEXTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 GEORGE ST STE J
BECKLEY WV
25801-2648
US

IV. Provider business mailing address

PO BOX 594
GLEN DANIEL WV
25844-0594
US

V. Phone/Fax

Practice location:
  • Phone: 304-929-2670
  • Fax:
Mailing address:
  • Phone: 304-299-4566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: