Healthcare Provider Details

I. General information

NPI: 1174434153
Provider Name (Legal Business Name): JACQUELINE NICHELLE FOSTER BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 US HIGHWAY 31 N
CARMEL IN
46032
US

IV. Provider business mailing address

7231 LACABREAH DR APT 203
BROWNSBURG IN
46112-5567
US

V. Phone/Fax

Practice location:
  • Phone: 317-582-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN9629330
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: