MEDICARE: ERICA NICOLE SEXTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)	094537711	TN

General Provider Information

NPI Number	:	1457773467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA NICOLE SEXTON

Provider Business Mailing Address
First Line	:	3614 SUMTER AVE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37406-2227
Country	:	US
Telephone Number	:	423-414-5694
Fax Number	:

Provider Business Practice Location Address
First Line	:	3614 SUMTER AVE
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37406-2227
Country	:	US
Telephone Number	:	423-414-5694
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/09/2014
Last Update Date	:	01/09/2014

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Directions to “ ERICA NICOLE SEXTON ” Practice Location

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