Decker, Kimberly K
Decker, Kimberly K is an individual health care provider with primary practice located at 3355 Eagle Park Dr Ne Suite 103, Grand Rapids MI 49525-7004. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Decker, Kimberly K can be contacted via phone (616) 942-7400.Contact Information
Primary practice address
3355 Eagle Park Dr Ne Suite 103
Grand Rapids MI 49525-7004
Phone: (616) 942-7400
Fax: (616) 942-7405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 5601004650 | Michigan |
Profile Details
| NPI number | 1164472619 |
|---|---|
| LBN Legal business name | Decker, Kimberly K |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | May 19th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164472619 | NPPES |
| Michigan | Other | 5601004650 | MICHIGAN LICENSE |
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