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1245668623
KELLY DIANA DECKARD
PHOENIX, AZ
NPI
1245668623
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: AZ 274000)
Enumeration Date
2013-10-23
Last Update Date
2024-06-21
Business Address
KELLY DIANA DECKARD FNP
2120 N CENTRAL AVE
PHOENIX, AZ 85004-1455
Phone number: 602-933-6100
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Mailing Address
KELLY DIANA DECKARD FNP
2108 E THOMAS RD STE 130
PHOENIX, AZ 85016-0008
Phone number: 602-933-1813
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