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NPI Code Detail

MEDICARE: BETH ANN DECKER FNP-C

MEDICARE: BETH ANN DECKER FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71010544AIN

General Provider Information

NPI Number : 1982088712
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETH ANN DECKER FNP-C
Provider Business Mailing Address
First Line : 6195 LUSK BLVD STE 250
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-3715
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17840 CUMBERLAND RD
Second Line :
City : NOBLESVILLE
State : IN
Zip : 46060-5409
Country : US
Telephone Number : 317-574-1254
Fax Number : 317-674-0060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2015
Last Update Date : 12/31/2025

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Directions to “ BETH ANN DECKER FNP-C” Practice Location

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