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General NPI Number Information
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NPI Number | 1790847044
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Entity Type | Individual
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Provider Name | TENITA PHILLIPS FOSTON FNP-C
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Gender | Female
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 10/25/2012
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE # B
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-4271
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Fax | 404-778-2925
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Provider Business Mailing Address
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Address Line | 3903 COOLWATER CIR
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City | SNELLVILLE
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State | GA
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Zip | 30039-5274
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Country | US
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Telephone | 404-991-4086
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Fax | 770-609-6730
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN119706NP
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License Number State | GA
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