Provider Demographics
NPI:1427897065
Name:FOSTER, STEPHANIE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6451 WELLS FARMS CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-0314
Mailing Address - Country:US
Mailing Address - Phone:901-270-9497
Mailing Address - Fax:901-205-0794
Practice Address - Street 1:3173 KIRBY WHITTEN RD STE 204
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2881
Practice Address - Country:US
Practice Address - Phone:901-498-0844
Practice Address - Fax:901-205-0794
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide