Decker, Kristopher Wyatt
Decker, Kristopher Wyatt is an individual health care provider with primary practice located at 222 Ashville Ave Ste 10 , Cary NC 27518-6130. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Decker, Kristopher Wyatt can be contacted via phone (919) 859-1136.Contact Information
Primary practice address
222 Ashville Ave Ste 10
Cary NC 27518-6130
Phone: (919) 859-1136
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 3643-23 | Wisconsin |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 0010-08659 | North Carolina |
Profile Details
| NPI number | 1154795227 |
|---|---|
| LBN Legal business name | Decker, Kristopher Wyatt |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2015 |
| Last updated | Mar 7th, 2023 - about 3 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 | 1154795227 | NPPES |
| Illinois | Other | 085-005532 | STATE OF IL |
| Illinois | Other | 0010-08659 | STATE OF IL |
| Illinois | Other | 3643-23 | STATE OF IL |
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