Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 9458694 | FL |
NPI | 1437684461 |
---|---|
Provider Name | Rachel Alexandra Decker |
First Address | Jacksonville, FL 32216-3623 |
Second Address | Jacksonville, FL 32204-4763 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2017 |
Last Update Date | 23/04/2018 |