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NPI Code Detail

MEDICARE: MS. ERICA LOUISE FOSTER R.N. W.C.C.

MEDICARE: MS. ERICA LOUISE FOSTER R.N. W.C.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
1163WW0000XWound Care Registered Nurse4704223644MI

General Provider Information

NPI Number : 1770843815
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ERICA LOUISE FOSTER R.N. W.C.C.
Provider Business Mailing Address
First Line : 1900 S LACHANCE RD
Second Line :
City : LAKE CITY
State : MI
Zip : 49651-8022
Country : US
Telephone Number : 231-775-3081
Fax Number :
Provider Business Practice Location Address
First Line : 1900 S LACHANCE RD
Second Line :
City : LAKE CITY
State : MI
Zip : 49651-8022
Country : US
Telephone Number : 231-775-3081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2012
Last Update Date : 05/23/2012

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