Individual
JESSICA C DECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3535 SOUTHERN BLVD, KETTERING, OH 45429-1221
(937) 395-8166
Mailing address
3131 NEWMARK DR STE 220, MIAMISBURG, OH 45342-5400
(937) 438-8910
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN.361849
OH
363L00000X
Nurse Practitioner
Primary
APRN.CNP.0030908
OH
363LF0000X
Family Nurse Practitioner
2021185662
OH
Other
Enumeration date
01/25/2022
Last updated
03/15/2022
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