| Doctor Name: | AMY M SANDUSKY |
| NPI Number: | 1164508834 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PA 2025 |
| Business Practice Address: | 707 N Iowa St Gunnison, CO - 812302229 |
| Business Phone Number: | 9706411399 |
| Business Fax Number: | 9706419017 |
| Mailing Address: | Po Box 839, GUNNISON |
| State: | CO |
| Postal Code: | 812300839 |
| Phone Number: | 9706411399 |
| Fax Number: | 9706419017 |
| NPI Enumeration Date: | 10/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | PA 2025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |