Provider Demographics
NPI:1427342492
Name:FOSTER, CONSTANCE H (D PH)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:H
Last Name:FOSTER
Suffix:
Gender:F
Credentials:D PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 WILLIAMSON SQ
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1314
Mailing Address - Country:US
Mailing Address - Phone:615-790-1177
Mailing Address - Fax:615-591-3650
Practice Address - Street 1:113 WILLIAMSON SQ
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1314
Practice Address - Country:US
Practice Address - Phone:615-790-1177
Practice Address - Fax:615-591-3650
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist