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NPI Code Detail

MEDICARE: MRS. CORY JO FOSTER RN

MEDICARE: MRS. CORY JO FOSTER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0200XSchool Registered Nurse105809SC
2363L00000XNurse Practitioner22246SC
3363LF0000XFamily Nurse Practitioner22246SC

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1SCE4935019OTHERSCMEDICARE PIN
3SCE4936084OTHERSCMEDICARE PIN
4SCE493J577OTHERSCMEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1083950935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CORY JO FOSTER RN
Provider Business Mailing Address
First Line : PO BOX 743070
Second Line :
City : ATLANTA
State : GA
Zip : 30374-3070
Country : US
Telephone Number : 864-560-4304
Fax Number : 864-560-4413
Provider Business Practice Location Address
First Line : 1330 BOILING SPRINGS RD STE 2500
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-4214
Country : US
Telephone Number : 864-585-5433
Fax Number : 864-591-4053
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2012
Last Update Date : 01/19/2023

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Directions to “ MRS. CORY JO FOSTER RN” Practice Location

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