Provider Demographics
NPI:1205405883
Name:SEXTON, LAUREL (NP-C)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:SEXTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:LAUREL
Other - Middle Name:
Other - Last Name:BODINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1107 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:IL
Mailing Address - Zip Code:62301-2600
Mailing Address - Country:US
Mailing Address - Phone:217-214-5800
Mailing Address - Fax:
Practice Address - Street 1:1107 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:IL
Practice Address - Zip Code:62301-2600
Practice Address - Country:US
Practice Address - Phone:217-214-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-18
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209023399363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily