Provider Demographics
NPI:1699510495
Name:NUSSER, MOLLY BETH (CSFA)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:BETH
Last Name:NUSSER
Suffix:
Gender:F
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8591 CROSSROAD DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44514-4382
Mailing Address - Country:US
Mailing Address - Phone:330-758-0577
Mailing Address - Fax:
Practice Address - Street 1:8591 CROSSROAD DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44514-4382
Practice Address - Country:US
Practice Address - Phone:330-758-0577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH203716246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist