Healthcare Provider Details

I. General information

NPI: 1386991099
Provider Name (Legal Business Name): RHIANNON BARTLESON FOSTER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2012
Last Update Date: 01/26/2022
Certification Date: 01/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOOPER RD
ENDWELL NY
13760-1560
US

IV. Provider business mailing address

346 GRAND AVE
JOHNSON CITY NY
13790-2580
US

V. Phone/Fax

Practice location:
  • Phone: 607-757-0444
  • Fax: 607-748-8984
Mailing address:
  • Phone: 607-729-8156
  • Fax: 607-729-3982

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number337514
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: