Provider Demographics
NPI:1558322404
Name:SEXSON, KATHRYN E (ANP, FNP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SEXSON
Suffix:
Gender:F
Credentials:ANP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2751 DEBARR RD
Mailing Address - Street 2:B-360
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2952
Mailing Address - Country:US
Mailing Address - Phone:907-277-4584
Mailing Address - Fax:907-277-3342
Practice Address - Street 1:2751 DEBARR RD
Practice Address - Street 2:B-360
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2952
Practice Address - Country:US
Practice Address - Phone:907-277-4584
Practice Address - Fax:907-277-3342
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2008-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK840OtherANP LICENSE
AKNP3602Medicaid
AK17310OtherRN LICENSE
AKNP3602Medicaid