Healthcare Provider Details

I. General information

NPI: 1255968798
Provider Name (Legal Business Name): JOCELYN ANNE FOSTER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JOCELYN ANNE ELWELL

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 10/19/2020
Certification Date: 10/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W MAIN ST STE B
MAPLE SHADE NJ
08052-2411
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-779-7386
  • Fax: 856-779-7563
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number26NJ00989500
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00989500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: