Healthcare Provider Details

I. General information

NPI: 1063433142
Provider Name (Legal Business Name): LILLIAN ADELE FOERSTER CRNP-P
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 03/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 FOREST GLEN RD
SILVER SPRING MD
20910-1483
US

IV. Provider business mailing address

122 LAFAYETTE AVE
LAUREL MD
20707-4512
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-3400
  • Fax:
Mailing address:
  • Phone: 301-498-5990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberR063555
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberR063555
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: