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
Fax: (616) 942-7405
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164472619 NPPES
Michigan Other 5601004650 MICHIGAN LICENSE

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