Doctor Name: | MRS. CAROLYN R. DECKER |
NPI Number: | 1003907106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, MSN, PNP |
License Number: | R052812 |
Business Practice Address: | 433 Edgewater Rd Pasadena, MD - 211225622 |
Business Phone Number: | 4102555864 |
Business Fax Number: | |
Mailing Address: | 433 Edgewater Rd, PASADENA |
State: | MD |
Postal Code: | 211225622 |
Phone Number: | 4102555864 |
Fax Number: | |
NPI Enumeration Date: | 09/27/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | R052812 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MD |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |