Provider Demographics
NPI:1578786901
Name:SEXTON, SARAH YOUNG (FNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:YOUNG
Last Name:SEXTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:SIMONS
Other - Last Name:FRASER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-2286
Mailing Address - Fax:
Practice Address - Street 1:200 PATEWOOD DR
Practice Address - Street 2:SUITE A200
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-3593
Practice Address - Country:US
Practice Address - Phone:864-454-5115
Practice Address - Fax:864-454-5141
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2667363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP1157Medicaid
SCAA24116904Medicare PIN
SCAA24117951Medicare PIN