Healthcare Provider Details

I. General information

NPI: 1881135473
Provider Name (Legal Business Name): NADEENA FOSTER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 02/02/2023
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 FARNAM ST STE 6
OMAHA NE
68131-3521
US

IV. Provider business mailing address

3402 DEWEY AVE
OMAHA NE
68105-1319
US

V. Phone/Fax

Practice location:
  • Phone: 402-451-5549
  • Fax:
Mailing address:
  • Phone: 402-312-1678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number39201810826
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: