Healthcare Provider Details

I. General information

NPI: 1700733037
Provider Name (Legal Business Name): CAROLYN FOSTER APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5506 NW NORTH CRISONA CIR
PORT ST LUCIE FL
34986-3629
US

IV. Provider business mailing address

5506 NW NORTH CRISONA CIR
PORT ST LUCIE FL
34986-3629
US

V. Phone/Fax

Practice location:
  • Phone: 754-368-5311
  • Fax:
Mailing address:
  • Phone: 754-368-5311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408328
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2025093409
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: