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DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SUSAN L. PROVOST

PRODUCER NON-RESIDENT

License Number:
PRN519861
Status:
First Licensure:
07/02/2025
Cancel Date:
None

Mailing:
KINGSTON, NY 12401
Phone:
+1 (845) 901-4178
Fax:
+1 (845) 853-8232
Email:
sprovost@nxginsurance.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 07/02/2025

Agency

Name Issue Date License Number Expiration Date Cancel Date
PATRIOT GROWTH INSURANCE SERVICES, LLC
07/03/2025 AGN313383

Employer

None.

Authority

Description Issue Date Termination Date Status
CASUALTY 07/02/2025 Active
PROPERTY 07/02/2025 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
4511490

Other Addresses

Address Type
159 GREEN ST
KINGSTON, NY 12401-3736
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 04/27/2026 05:34:46 AM