MEDICARE: MRS. LENORA MARIE FOSTER CPNP

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	363L00000X	Nurse Practitioner	4704201257	MI
2	363LP0200X	Pediatric Nurse Practitioner	4704201257	MI

General Provider Information

NPI Number	:	1124394259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LENORA MARIE FOSTER CPNP

Provider Business Mailing Address
First Line	:	1150 E LANTZ ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48203-1376
Country	:	US
Telephone Number	:	313-368-4139
Fax Number	:	313-368-4470

Provider Business Practice Location Address
First Line	:	1150 E LANTZ ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48203-1376
Country	:	US
Telephone Number	:	313-368-4139
Fax Number	:	313-368-4470

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2012
Last Update Date	:	12/01/2025

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