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General NPI Number Information
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NPI Number | 1760966444
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Entity Type | Individual
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Provider Name | JESSICA ANDERSON FOSTER LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | D3238 MESSINA ST
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City | FORT BRAGG
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State | NC
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Zip | 28310-7324
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Country | US
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Telephone | 336-862-0307
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Fax |
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Provider Business Mailing Address
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Address Line | D3238 MESSINA ST
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City | FORT BRAGG
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State | NC
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Zip | 28310-7324
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Country | US
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Telephone | 336-862-0307
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-5959
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT.0002018
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License Number State | CO
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