Healthcare Provider Details

I. General information

NPI: 1841046091
Provider Name (Legal Business Name): SYDNEY LINN FOSTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 06/24/2024
Certification Date: 06/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W MAPLE AVE STE 205A
SPRINGDALE AR
72764-5336
US

IV. Provider business mailing address

601 W MAPLE AVE STE 205A
SPRINGDALE AR
72764-5336
US

V. Phone/Fax

Practice location:
  • Phone: 479-326-9400
  • Fax: 479-309-9693
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-1285
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: