Provider Demographics
NPI:1699517706
Name:FOSTER, EMILY NOEL (PHARMD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:NOEL
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 E STONERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65803-4818
Mailing Address - Country:US
Mailing Address - Phone:417-319-9501
Mailing Address - Fax:
Practice Address - Street 1:1930 W GRAND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4870
Practice Address - Country:US
Practice Address - Phone:417-863-6416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024032487183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist