Provider Demographics
NPI:1255355236
Name:SEXTON, CALLIE MINTER (FAMILY NURSE PRACTIT)
Entity type:Individual
Prefix:MS
First Name:CALLIE
Middle Name:MINTER
Last Name:SEXTON
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5552 MEADOWSWEET CIR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-8820
Mailing Address - Country:US
Mailing Address - Phone:318-747-3550
Mailing Address - Fax:
Practice Address - Street 1:207 W CALHOUN
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:AR
Practice Address - Zip Code:71753-3506
Practice Address - Country:US
Practice Address - Phone:870-235-3798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01818363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily