Healthcare Provider Details

I. General information

NPI: 1538063920
Provider Name (Legal Business Name): MAKAYLA DECKER BSN,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1152 SAINT MARYS AVE
SIDNEY OH
45365-8901
US

IV. Provider business mailing address

1152 SAINT MARYS AVE
SIDNEY OH
45365-8901
US

V. Phone/Fax

Practice location:
  • Phone: 937-497-2231
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.511197
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: