Provider Demographics
NPI:1578817698
Name:SEXTON, CHERIE LYNN (CPNP)
Entity Type:Individual
Prefix:
First Name:CHERIE
Middle Name:LYNN
Last Name:SEXTON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 NAVARRE AVE STE 315
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3224
Mailing Address - Country:US
Mailing Address - Phone:419-696-6336
Mailing Address - Fax:614-696-6337
Practice Address - Street 1:2702 NAVARRE AVE STE 315
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3224
Practice Address - Country:US
Practice Address - Phone:419-696-6336
Practice Address - Fax:614-696-6337
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704294979363LP0200X
OHCOA 13698-NP363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0079278Medicaid