Individual
ELLEN DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 831-5547
(616) 831-5548
Mailing address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 831-5547
(616) 831-5548
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704128078
MI
Other
Enumeration date
04/21/2015
Last updated
04/21/2015
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