Healthcare Provider Details

I. General information

NPI: 1528631066
Provider Name (Legal Business Name): QUESHA KATHLEEN FOSTER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 E COLLEGE ST STE B
GRIFFIN GA
30224-4348
US

IV. Provider business mailing address

226 E COLLEGE ST STE B
GRIFFIN GA
30224-4348
US

V. Phone/Fax

Practice location:
  • Phone: 678-987-1490
  • Fax: 678-987-1491
Mailing address:
  • Phone: 678-987-1490
  • Fax: 678-987-1491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61208460
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN-NP255164
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: