Healthcare Provider Details

I. General information

NPI: 1639832694
Provider Name (Legal Business Name): SHARRON FOSTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2021
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 W TYLER AVE
WEST MEMPHIS AR
72301-4149
US

IV. Provider business mailing address

PO BOX 2192
FORREST CITY AR
72336-2192
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-2737
  • Fax: 870-551-3724
Mailing address:
  • Phone: 870-208-8362
  • Fax: 870-551-3724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR090411
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: