Provider Demographics
NPI:1740750058
Name:DECKER, BARBARA ANNE
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:DECKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 SHEERAN RD
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5225
Mailing Address - Country:US
Mailing Address - Phone:860-583-6391
Mailing Address - Fax:
Practice Address - Street 1:75 N MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06053-3468
Practice Address - Country:US
Practice Address - Phone:860-229-6820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-29
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTE56751163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse