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NPI Code Detail

MEDICARE: YANCEY ROY FOSTER FNP

MEDICARE: YANCEY ROY FOSTER FNP
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
1363L00000XNurse Practitioner669429TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1669429OTHERTXNURSE PRACTITIONERS

General Provider Information

NPI Number : 1255343745
Entity Type Code : Individual
Provider Name (Legal Business Name) : YANCEY ROY FOSTER FNP
Provider Business Mailing Address
First Line : 2342 EARLE ST
Second Line :
City : PORT NECHES
State : TX
Zip : 77651-4414
Country : US
Telephone Number : 409-540-0971
Fax Number :
Provider Business Practice Location Address
First Line : 3080 COLLEGE ST
Second Line :
City : BEAUMONT
State : TX
Zip : 77701-4606
Country : US
Telephone Number : 409-835-3781
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 07/08/2007

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