MEDICARE: EMERALD LYNN FOUST PA-C

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	363A00000X	Physician Assistant	OA006288	PA

General Provider Information

NPI Number	:	1225754591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMERALD LYNN FOUST PA-C

Provider Business Mailing Address
First Line	:	16954 CONNEAUT LAKE RD
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3738
Country	:	US
Telephone Number	:	814-200-9904
Fax Number	:

Provider Business Practice Location Address
First Line	:	16954 CONNEAUT LAKE RD
Second Line	:
City	:	MEADVILLE
State	:	PA
Zip	:	16335-3738
Country	:	US
Telephone Number	:	814-200-9904
Fax Number	:

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

Provider Enumeration Date	:	10/18/2022
Last Update Date	:	05/29/2026

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