Individual
MRS. AMANDA SUE DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1102 N MASSEY BLVD, NIXA, MO 65714-7607
(417) 724-0798
Mailing address
180 MEADOWBROOK, WALNUT SHADE, MO 65771-9332
(417) 294-4085
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
2001023388
MO
183500000X
Pharmacist
PD09323
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2001023388
MO LISC
MO
05
—
35914908
—
MO
01
—
PD09323
AR LISC
AR
Enumeration date
08/11/2006
Last updated
09/12/2024
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