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General NPI Number Information
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NPI Number | 1942908488
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Entity Type | Organization
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Legal Business Name | FOSTER WELLNESS, LLC
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Dates
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Enumeration Date | 02/22/2023
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 10400 BLACKLICK EASTERN RD STE 130
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City | PICKERINGTON
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State | OH
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Zip | 43147-7702
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Country | US
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Telephone | 305-367-8378
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Fax | 614-639-8001
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Provider Business Mailing Address
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Address Line | 10400 BLACKLICK EASTERN RD STE 110
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City | PICKERINGTON
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State | OH
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Zip | 43147-7702
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Country | US
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Telephone | 305-367-8378
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Fax | 614-639-8001
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Authorized Official
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Title or Position | CEO/NURSE PRACTITIONER
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Name | MICHELLE MARKO
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Credential | APRN
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Telephone | 614-578-8768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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