Basic Information
| Provider Information | |||||||||
| NPI: | 1659777696 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SEXTON | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | |||||||||
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| Credential: | RN, MSN NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1916 NW COPPER OAKS CIR | ||||||||
| Address2: | |||||||||
| City: | BLUE SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640158300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137088258 | ||||||||
| FaxNumber: | 9137088289 | ||||||||
| Practice Location | |||||||||
| Address1: | 1916 NW COPPER OAKS CIR | ||||||||
| Address2: | |||||||||
| City: | BLUE SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 640158300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9137088258 | ||||||||
| FaxNumber: | 9137088289 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/18/2014 | ||||||||
| LastUpdateDate: | 02/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 2014037314 | MO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.