Healthcare Provider Details

I. General information

NPI: 1851707822
Provider Name (Legal Business Name): KATHRYN FOSTER HERB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHRYN FOSTER WALSH

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 03/24/2020
Certification Date: 03/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4551 NEW BERN AVE STE 160
RALEIGH NC
27610
US

IV. Provider business mailing address

200 PARK AT NORTH HILLS ST APT 508
RALEIGH NC
27609-2638
US

V. Phone/Fax

Practice location:
  • Phone: 919-556-1008
  • Fax: 919-556-6099
Mailing address:
  • Phone: 919-452-4313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number674666
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number339328
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9438326
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012897
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: