Healthcare Provider Details

I. General information

NPI: 1629737739
Provider Name (Legal Business Name): JESSICA E FOUST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 E. BIDDLE ST
JACKSON MI
49203-9000
US

IV. Provider business mailing address

11581 CHICAGO RD
JEROME MI
49249-9000
US

V. Phone/Fax

Practice location:
  • Phone: 517-783-3434
  • Fax:
Mailing address:
  • Phone: 517-812-1922
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number6801118846
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: