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General NPI Number Information
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NPI Number | 1972136323
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Entity Type | Individual
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Provider Name | GINA DECKER MS, RD, LD
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Gender | Female
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Dates
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Enumeration Date | 02/13/2020
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 80 PALOMINO LN STE 101
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City | BEDFORD
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State | NH
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Zip | 03110-6447
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Country | US
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Telephone | 207-907-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 20 SANDHILL DR
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City | MERRIMACK
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State | NH
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Zip | 03054-3287
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Country | US
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Telephone | 603-913-7749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI1500
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1068
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License Number State | NH
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