Provider Demographics
NPI:1851799902
Name:SEXTON, ELLEN SCHOENLE (PA-C)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:SCHOENLE
Last Name:SEXTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:4601 CAROTHERS PKWY
Practice Address - Street 2:SUITE 375
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5976
Practice Address - Country:US
Practice Address - Phone:615-791-4790
Practice Address - Fax:615-791-4531
Is Sole Proprietor?:No
Enumeration Date:2014-12-05
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2641363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ015571Medicaid