Provider Demographics
NPI:1699472381
Name:DECKER, ALEXIS (FNP)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:DECKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4242 GERBERA LN APT C
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7156
Mailing Address - Country:US
Mailing Address - Phone:419-966-9695
Mailing Address - Fax:
Practice Address - Street 1:4242 GERBERA LN APT C
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-7156
Practice Address - Country:US
Practice Address - Phone:419-966-9695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-13
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0033234363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily