Provider Demographics
NPI:1437684461
Name:DECKER, RACHEL ALEXANDRA (ARNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ALEXANDRA
Last Name:DECKER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 BELFORT RD STE 4015
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-3623
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:904-450-6401
Practice Address - Street 1:2 SHIRCLIFF WAY STE 435
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204-4763
Practice Address - Country:US
Practice Address - Phone:904-308-6900
Practice Address - Fax:904-308-6927
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9458694163W00000X, 363LC0200X
CT129296163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163W00000XNursing Service ProvidersRegistered Nurse