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General NPI Number Information
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NPI Number | 1316049497
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Entity Type | Individual
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Provider Name | THERESA MARY SEXTON APRN
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Gender | Female
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 142 MILESTONE WAY
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City | GREENVILLE
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State | SC
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Zip | 29615-5065
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Country | US
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Telephone | 864-558-0092
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Fax | 855-269-6611
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Provider Business Mailing Address
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Address Line | 142 MILESTONE WAY
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City | GREENVILLE
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State | SC
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Zip | 29615-5065
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Country | US
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Telephone | 864-558-0092
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Fax | 855-269-6611
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APN19435
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | ARNP1755352
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 19435
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License Number State | SC
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