Jerome Joseph Dedecker Valid NPI

Individual provider · Registered Nurse · Seligman, AZ

NPI

1225603327

Type

Individual (Type 1)

Primary specialty

Registered Nurse

Specialty group

Nursing Service Providers

Taxonomy code

163W00000X

License number

B12876871 (AZ)

Sex

Male

Sole proprietor

Yes

Enumerated

2021-05-21

Last updated

2021-05-21