Provider Demographics
NPI:1669098463
Name:DECKER, ALISHIA D (FNP)
Entity type:Individual
Prefix:
First Name:ALISHIA
Middle Name:D
Last Name:DECKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1641 TEXOWA RD
Mailing Address - Street 2:
Mailing Address - City:IOWA PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76367-1190
Mailing Address - Country:US
Mailing Address - Phone:940-867-7452
Mailing Address - Fax:
Practice Address - Street 1:2304 9TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4031
Practice Address - Country:US
Practice Address - Phone:940-867-7452
Practice Address - Fax:940-234-9008
Is Sole Proprietor?:No
Enumeration Date:2020-06-18
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1017770363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily