Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | R194536 | MD |
N | 363LP2300X | Nurse Practitioner - Primary Care | SP018676 | PA |
NPI | 1023511706 |
---|---|
Provider Name | Jennifer Lyn Foster |
First Address | Hagerstown, MD 21742-6727 |
Second Address | Hagerstown, MD 21740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2018 |
Last Update Date | 21/05/2019 |