Most Relevant Information
Provider Data
| NPI Number: | 1003469925 |
| Provider Name: | SHANNON L DECKER |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 28202903A |
Most Important Dates
| Enumeration Date: | 07/19/2019 |
| Last Updated: | 03/14/2024 |
Provider Practice Location
11108 PARKVIEW CIRCLE DR
FORT WAYNE
IN
468451730
Practice Location Phone/Fax
| Phone: | 2602665700 |
| Fax: | 2602665910 |
Provider Mailing Location
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE
IN
468451701
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |