Provider Demographics
NPI:1619665122
Name:DECKER, VICTORIA (RN, DN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:DECKER
Suffix:
Gender:F
Credentials:RN, DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19939 TYGART LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-4537
Mailing Address - Country:US
Mailing Address - Phone:240-464-3908
Mailing Address - Fax:
Practice Address - Street 1:19939 TYGART LN
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-4537
Practice Address - Country:US
Practice Address - Phone:240-464-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health