Basic Information
| Provider Information | |||||||||
| NPI: | 1578870218 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEWKSBURY | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | G. | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MNT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 ST. JOHNSBURY ROAD | ||||||||
| Address2: | C/O LITTLETON REGIONAL HOSPITAL | ||||||||
| City: | LITTLETON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035610000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034449000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 600 ST. JOHNSBURY ROAD | ||||||||
| Address2: | C/O LITTLETON REGIONAL HOSPITAL | ||||||||
| City: | LITTLETON | ||||||||
| State: | NH | ||||||||
| PostalCode: | 035610000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6034449000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2010 | ||||||||
| LastUpdateDate: | 09/01/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 340 | NH | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.