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Individual

MS. MARIE SANDUSKY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, APN

Contact information

Practice address
2801 S UNIVERSITY AVE, DSC 102, LITTLE ROCK, AR 72204-1000
(501) 569-3188
(501) 683-7654
Mailing address
2801 S UNIVERSITY AVE, DSC 102, LITTLE ROCK, AR 72204-1000
(501) 569-3188
(501) 683-7654

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
R28118
AR
363LF0000X
Family Nurse Practitioner
Primary
A01089 ANP
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A01089 ANP
APN
Enumeration date
12/14/2007
Last updated
04/16/2008
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