Provider Demographics
NPI:1063017820
Name:FOSTER, JAMES CARLISLE IV (APRN)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:CARLISLE
Last Name:FOSTER
Suffix:IV
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:TRAVELERS REST
Mailing Address - State:SC
Mailing Address - Zip Code:29690-2221
Mailing Address - Country:US
Mailing Address - Phone:864-430-6725
Mailing Address - Fax:
Practice Address - Street 1:322 WATSON RD
Practice Address - Street 2:
Practice Address - City:TRAVELERS REST
Practice Address - State:SC
Practice Address - Zip Code:29690-2221
Practice Address - Country:US
Practice Address - Phone:864-430-6725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24195363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily