NPI | 1528069531 |
---|---|
Former Name | MISTY R DECKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KY 3004253) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3004253) |
Enumeration Date | 2005-08-02 |
Last Update Date | 2025-02-22 |