| Doctor Name: | DR. SANDRA ELIZABETH NUSSEY |
| NPI Number: | 1932515202 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 01075933A |
| Business Practice Address: | 18th Medical Group Unit 5142 Apo, AP - 963680000 |
| Business Phone Number: | 3156346020 |
| Business Fax Number: | |
| Mailing Address: | Psc 80 Box 11934, APO |
| State: | AP |
| Postal Code: | 963670022 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/08/2014 |
| NPI Last Update Date: | 11/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 01075933A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |