Individual
CHELSEA LYNN SANDUSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4475 S EASTERN AVE, LAS VEGAS, NV 89119-7826
(702) 669-5811
(702) 650-2458
Mailing address
PO BOX 15645, LAS VEGAS, NV 89114-5645
(702) 579-3270
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA1222
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962716266
—
NV
Enumeration date
07/29/2010
Last updated
04/23/2015
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