Provider Demographics
NPI:1154771947
Name:FOSTER, AMANDA DARLENE (RNC)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:DARLENE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RNC
Other - Prefix:MRS
Other - First Name:AMANDA
Other - Middle Name:DARLENE
Other - Last Name:HOUGHTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:89 N BYPASS RD
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-1500
Mailing Address - Country:US
Mailing Address - Phone:912-429-1930
Mailing Address - Fax:
Practice Address - Street 1:89 N BYPASS RD
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-1500
Practice Address - Country:US
Practice Address - Phone:912-429-1930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN135267163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse