Shannon L Decker
Nurse Practitioner
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
Shannon L Decker
Nurse Practitioner
11108 Parkview Circle Dr
Fort Wayne
, Indiana 46845-1730
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About
Features
Specialties
- Nurse Practitioner
Languages spoken
- English
Location
First Address
- Shannon L Decker
- 11109 Parkview Plaza Dr # 117
- Fort Wayne, IN
- Zip : 46845-1701
- Phone :
Second Address
- Shannon L Decker
- 11108 Parkview Circle Dr
- Fort Wayne, IN
- Zip : 46845-1730
- Fax : (260) 266-5910
- Phone : (260) 266-5700
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 71009255A | IN |
National Provider Identifier
| NPI | 1003469925 |
|---|---|
| Provider Name | Shannon L Decker |
| First Address | Fort Wayne, IN 46845-1701 |
| Second Address | Fort Wayne, IN 46845-1730 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 19/07/2019 |
| Last Update Date | 14/04/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.