Healthcare Provider Details

I. General information

NPI: 1568549616
Provider Name (Legal Business Name): MS. JOY FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 COMMERCE PARK
ELLSWORTH ME
04605-3383
US

IV. Provider business mailing address

37 COMMERCE PARK
ELLSWORTH ME
04605-3383
US

V. Phone/Fax

Practice location:
  • Phone: 207-667-2422
  • Fax:
Mailing address:
  • Phone: 207-667-2422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR08706
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: