Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 2017036296 | MO |
NPI | 1033636162 |
---|---|
Provider Name | Shari Ann Decker |
First Address | Kansas City, MO 64111-3220 |
Second Address | Kansas City, MO 64111-3220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2017 |
Last Update Date | 28/02/2018 |