Provider Demographics
NPI:1932739554
Name:SEXTON, LELAND JAY JR (APRN)
Entity Type:Individual
Prefix:
First Name:LELAND
Middle Name:JAY
Last Name:SEXTON
Suffix:JR
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 GREENBRIAR DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:KY
Mailing Address - Zip Code:41143-1746
Mailing Address - Country:US
Mailing Address - Phone:606-316-4454
Mailing Address - Fax:
Practice Address - Street 1:224 GREENBRIAR DR
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1746
Practice Address - Country:US
Practice Address - Phone:606-316-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3013247363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily