MEDICARE: FOSTERS AFTERHOURS PRIMARY CARE AND COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1053280875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FOSTERS AFTERHOURS PRIMARY CARE AND COUNSELING

Provider Business Mailing Address
First Line	:	397 WALLACE RD STE 300
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-8012
Country	:	US
Telephone Number	:	615-953-0323
Fax Number	:

Provider Business Practice Location Address
First Line	:	4604 LANCASTER RD
Second Line	:
City	:	SMYRNA
State	:	TN
Zip	:	37167-3447
Country	:	US
Telephone Number	:	615-953-0323
Fax Number	:

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	MS. LISA EVANS
Credential	:
Telephone Number	:	615-953-0323

Provider Enumeration Date	:	10/31/2025
Last Update Date	:	04/08/2026

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