Individual
DR. NANETTE S. NUESSLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7219 N LITCHFIELD RD, BLDG 1130, GLENDALE, AZ 85309
(623) 856-4029
Mailing address
11630 N REEMS RD, #2051, SURPRISE, AZ 85374
(913) 948-3323
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036-087877
IL
208000000X
Pediatrics Physician
04-34846
KS
208000000X
Pediatrics Physician
Primary
47491
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036087877 1
—
IL
01
—
04-34846
KANSAS LICENSE
—
01
—
279500
MEDICARE GROUP
—
Enumeration date
08/01/2006
Last updated
08/05/2016
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