Provider Demographics
NPI:1487387494
Name:FOSTER, HOLLI LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:HOLLI
Middle Name:LYNN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:HOLLI
Other - Middle Name:LYNN
Other - Last Name:HESLOP
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 422
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:OH
Mailing Address - Zip Code:44446-0422
Mailing Address - Country:US
Mailing Address - Phone:330-984-2352
Mailing Address - Fax:
Practice Address - Street 1:412 STANTON AVE
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-1524
Practice Address - Country:US
Practice Address - Phone:330-984-2352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031662363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily