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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. TERESA MARIE ENNIS-DECKER, O.D.

Deactivated Sole Proprietor

MRS. TERESA MARIE ENNIS-DECKER, O.D. is a Optometrist healthcare provider located in MILLINGTON, Michigan. NPI 1154322956 is deactivated in the NPPES registry. Verify at CMS.

Optometrist · MILLINGTON, MI

This NPI has been deactivated. The record was deactivated on March 21, 2006. Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated. Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.

Registration Details

NPI Number
1154322956
Provider Type
Individual
Gender
Female
NPI Issued
Aug 3, 2005 (0.63013698630137 yrs)
Last Updated
Jul 3, 2012
Deactivated
Mar 21, 2006
License
4901003316 (MI)
Sole Proprietor
Yes

Practice Information

Address
9575 STATE RD
MILLINGTON, MI, 487469482
Browse MI providers · Browse ZIP 48746
Phone
9898719552
Fax
9898719554
Primary Specialty
Optometrist
152W00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.