Provider Demographics
NPI:1619600079
Name:SEXTON, TAMMY JEAN (LPN)
Entity Type:Individual
Prefix:
First Name:TAMMY
Middle Name:JEAN
Last Name:SEXTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3342 BIG RUN RD
Mailing Address - Street 2:
Mailing Address - City:LUCASVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45648-8910
Mailing Address - Country:US
Mailing Address - Phone:740-821-5576
Mailing Address - Fax:
Practice Address - Street 1:840 GALLIA ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-4232
Practice Address - Country:US
Practice Address - Phone:740-353-3236
Practice Address - Fax:740-353-4803
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.145765.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse