Individual
JACLYNN DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
16455 STATESVILLE RD, STE 200, HUNTERSVILLE, NC 28078-7135
(704) 302-8600
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
102240
NC
Other
Enumeration date
08/16/2006
Last updated
09/27/2021
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