Provider Demographics
NPI:1639896749
Name:DECKER, RUTH (RN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:
Last Name:DECKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 JACKSON ST UNIT C4
Mailing Address - Street 2:
Mailing Address - City:ESSEX JCT
Mailing Address - State:VT
Mailing Address - Zip Code:05452-4703
Mailing Address - Country:US
Mailing Address - Phone:802-309-5713
Mailing Address - Fax:
Practice Address - Street 1:43 JACKSON ST UNIT C4
Practice Address - Street 2:
Practice Address - City:ESSEX JCT
Practice Address - State:VT
Practice Address - Zip Code:05452-4703
Practice Address - Country:US
Practice Address - Phone:802-309-5713
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-20
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT026.0112883163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health