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Individual
CARLY DECKER
Active
Individual
CARLY DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
133977
IA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1051175
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
404902
NY
Other
Enumeration date
07/27/2020
Last updated
12/09/2025
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