MEDICARE: DEANNE MARIE FOSTER MS, RD, LD

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	133V00000X	Registered Dietitian	615	OK

General Provider Information

NPI Number	:	1922827302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANNE MARIE FOSTER MS, RD, LD

Provider Business Mailing Address
First Line	:	9500 LARIMORE LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73151-9173
Country	:	US
Telephone Number	:	405-850-2592
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 LARIMORE LN
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73151-9173
Country	:	US
Telephone Number	:	405-850-2592
Fax Number	:

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

Provider Enumeration Date	:	10/03/2024
Last Update Date	:	10/03/2024

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