Healthcare Provider Details

I. General information

NPI: 1851238125
Provider Name (Legal Business Name): CALLIE FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 S MAIN ST
INDEPENDENCE MO
64050-4417
US

IV. Provider business mailing address

907 S MAIN ST
INDEPENDENCE MO
64050-4417
US

V. Phone/Fax

Practice location:
  • Phone: 816-419-7065
  • Fax:
Mailing address:
  • Phone: 816-419-7065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2017001254
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: