Individual
MISS KRISTEN K DECKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
24086 BOWENS PRAIRIE RD, MONTICELLO, IA 52310-8101
(319) 480-8296
Mailing address
24086 BOWENS PRAIRIE RD, MONTICELLO, IA 52310-8101
(319) 480-8296
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
001944
IA
133V00000X
Registered Dietitian
DT83631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001944
IOWA DIETETIC LICENSURE
IA
01
—
1891096863
NPI
TX
Enumeration date
11/08/2010
Last updated
12/06/2015
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