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General NPI Number Information
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NPI Number | 1306823703
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Entity Type | Individual
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Provider Name | ELAINE NICOLE SEXTON RN
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 217 FT. RICHARDSON AVE 17 MEDICAL GROUP
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City | GOODFELLOW AFB
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State | TX
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Zip | 76908
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Country | US
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Telephone | 325-654-3117
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Fax |
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Provider Business Mailing Address
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Address Line | 271 FT. RICHARDSON AVE 17 MEDICAL GROUP
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City | GOODFELLOW AFB
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State | TX
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Zip | 76908
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN41041
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 0001216785
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License Number State | VA
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