Provider Demographics
NPI:1578441432
Name:SEXTON, BRADLEY I (LPN)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:I
Last Name:SEXTON
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 OWL CREEK CUTOFF
Mailing Address - Street 2:
Mailing Address - City:ROYAL
Mailing Address - State:AR
Mailing Address - Zip Code:71968-9414
Mailing Address - Country:US
Mailing Address - Phone:501-762-3697
Mailing Address - Fax:
Practice Address - Street 1:531 OWL CREEK CUTOFF
Practice Address - Street 2:
Practice Address - City:ROYAL
Practice Address - State:AR
Practice Address - Zip Code:71968-9414
Practice Address - Country:US
Practice Address - Phone:501-762-3697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARL059616164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse