Provider Demographics
NPI:1982983722
Name:GODREAU SEXTON, PATRICIA JEAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:JEAN
Last Name:GODREAU SEXTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2383 STATE ROUTE 458
Mailing Address - Street 2:
Mailing Address - City:SAINT REGIS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12980-3407
Mailing Address - Country:US
Mailing Address - Phone:518-856-9294
Mailing Address - Fax:
Practice Address - Street 1:92 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:ST. REGIS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12980
Practice Address - Country:US
Practice Address - Phone:518-856-9421
Practice Address - Fax:518-856-0142
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY401567163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse