Provider Demographics
NPI:1922525518
Name:DECKER, JAMIE ELIZABETH (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:DECKER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:ELIZABETH
Other - Last Name:WALDORF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:160 W GRANITE ST APT A
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-9261
Mailing Address - Country:US
Mailing Address - Phone:406-490-5220
Mailing Address - Fax:
Practice Address - Street 1:160 W GRANITE ST APT A
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9261
Practice Address - Country:US
Practice Address - Phone:406-302-2808
Practice Address - Fax:406-299-3323
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-127183207Q00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine