# LISA DECKER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1790123842
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP0808X | Psychiatric/Mental Health Registered Nurse | 1135114 | KY | Yes |

## Other

- **Enumeration date:** 06/11/2013
- **Last updated:** 06/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 610661458 | TAX ID | KY |