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Individual

MS. ANDREA LEIGH DECKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
111 COLCHESTER AVE, FAHC EMERGENCY DEPARTMENT, BURLINGTON, VT 05401-1473
(802) 847-1237
(802) 847-5963
Mailing address
129 COBBLESTONE CIR, SOUTH BURLINGTON, VT 05403-7606

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
026780
NY
363A00000X
Physician Assistant
Primary
55-0030650
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9000163
VT
Enumeration date
07/11/2006
Last updated
12/20/2021
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