Individual
MS. AMANDA M DECIMO
Active
Individual
MS. AMANDA M DECIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209.007301
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
308217200
—
FL
01
—
G4231
BCBSFL
—
Enumeration date
03/09/2007
Last updated
01/06/2015
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