Provider Demographics
NPI:1083344980
Name:SEXTON, CHARONE (NP)
Entity Type:Individual
Prefix:
First Name:CHARONE
Middle Name:
Last Name:SEXTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1460 S BAKER RD
Mailing Address - Street 2:
Mailing Address - City:WELLSTON
Mailing Address - State:MI
Mailing Address - Zip Code:49689-9710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6227 FRANKFORT HWY
Practice Address - Street 2:
Practice Address - City:BENZONIA
Practice Address - State:MI
Practice Address - Zip Code:49616-8632
Practice Address - Country:US
Practice Address - Phone:231-882-9661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704296558363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily