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General NPI Number Information
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NPI Number | 1184496515
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Entity Type | Organization
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Legal Business Name | BRIAN J. DECKER, MSN, FNPC, PC
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Dates
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Enumeration Date | 10/30/2023
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 3863 E 300 N
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City | RIGBY
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State | ID
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Zip | 83442-5423
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Country | US
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Telephone | 208-403-4140
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Fax |
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Provider Business Mailing Address
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Address Line | 3863 E 300 N
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City | RIGBY
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State | ID
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Zip | 83442-5423
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Country | US
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Telephone | 208-403-4140
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | BRIAN J DECKER
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Credential | APRN
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Telephone | 208-403-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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