Provider Demographics
NPI:1124886494
Name:FOSTER, SELINA (FNP-BC)
Entity type:Individual
Prefix:
First Name:SELINA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 W CENTER ST STE 5
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1542
Mailing Address - Country:US
Mailing Address - Phone:508-583-1100
Mailing Address - Fax:508-583-1120
Practice Address - Street 1:711 W CENTER ST STE 5
Practice Address - Street 2:
Practice Address - City:WEST BRIDGEWATER
Practice Address - State:MA
Practice Address - Zip Code:02379-1542
Practice Address - Country:US
Practice Address - Phone:508-583-1100
Practice Address - Fax:508-583-1120
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2023189493363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily