Healthcare Provider Details

I. General information

NPI: 1932562279
Provider Name (Legal Business Name): TALEA FOSTER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2016
Last Update Date: 10/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 W LONG ST
COLUMBUS OH
43215-2815
US

IV. Provider business mailing address

16 W LONG ST
COLUMBUS OH
43215-2815
US

V. Phone/Fax

Practice location:
  • Phone: 614-225-0990
  • Fax: 614-225-0988
Mailing address:
  • Phone: 614-225-0990
  • Fax: 614-225-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLE-00029738
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.025766
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.411377
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number620107010375694
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: