Provider Demographics
NPI:1013507797
Name:DECKER, AMANDA (CRNP, PMHNP)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:DECKER
Suffix:
Gender:F
Credentials:CRNP, PMHNP
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:
Other - Last Name:DECKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18962-0473
Mailing Address - Country:US
Mailing Address - Phone:609-757-9558
Mailing Address - Fax:
Practice Address - Street 1:65 S MAIN ST STE C101
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-2847
Practice Address - Country:US
Practice Address - Phone:097-579-5586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13168600363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health