Individual
BETH GINGRICH DECKARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
21 SUSQUEHANNA VALLEY MALL DR STE A, SELINSGROVE, PA 17870-9148
(570) 374-7852
(570) 374-7932
Mailing address
7 DOCK HILL RD, MIDDLEBURG, PA 17842-8910
(570) 837-2123
(570) 837-2185
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN266917L
PA
363L00000X
Nurse Practitioner
Primary
SP005262B
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1031841380001
—
PA
Enumeration date
06/06/2006
Last updated
04/14/2022
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