Provider Demographics
NPI:1336547652
Name:FOSTER, MARY ELIZABETH (CNM)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ELIZABETH
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CNM
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Mailing Address - Street 1:661 E ALTAMONTE DR STE 328
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32701-5103
Mailing Address - Country:US
Mailing Address - Phone:407-303-5204
Mailing Address - Fax:407-303-5205
Practice Address - Street 1:661 E ALTAMONTE DR STE 328
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32701-5103
Practice Address - Country:US
Practice Address - Phone:407-303-5204
Practice Address - Fax:407-303-5205
Is Sole Proprietor?:No
Enumeration Date:2014-12-18
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLRN 743652163W00000X
FLARNP9327743367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse