Provider Demographics
NPI:1558541680
Name:SEXTON, SUZANNE LEIGH (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:SUZANNE
Middle Name:LEIGH
Last Name:SEXTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:11960 LIONESS WAY 210
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-5644
Mailing Address - Country:US
Mailing Address - Phone:303-695-6106
Mailing Address - Fax:303-695-1211
Practice Address - Street 1:395 N SILVERBELL RD
Practice Address - Street 2:#315
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2675
Practice Address - Country:US
Practice Address - Phone:520-623-8475
Practice Address - Fax:520-297-3539
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2015-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO4280363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ299343Medicaid
AZ299343Medicaid
AZE52307Medicare UPIN