Provider Demographics
NPI:1154518595
Name:FOSTER, KATHERINE PAT (FNP)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:PAT
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:PAT
Other - Last Name:SAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4405 CENTRAL AVENUE PIKE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-4077
Mailing Address - Country:US
Mailing Address - Phone:865-247-7045
Mailing Address - Fax:865-249-8458
Practice Address - Street 1:4405 CENTRAL AVENUE PIKE
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-4077
Practice Address - Country:US
Practice Address - Phone:865-247-7045
Practice Address - Fax:865-249-8458
Is Sole Proprietor?:No
Enumeration Date:2007-10-01
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5198363LF0000X, 364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1515276Medicaid