Provider Demographics
NPI:1083950935
Name:FOSTER, CORY JO (RN)
Entity Type:Individual
Prefix:MRS
First Name:CORY
Middle Name:JO
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:CORY
Other - Middle Name:JO
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:1330 BOILING SPRINGS RD STE 2500
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-4214
Practice Address - Country:US
Practice Address - Phone:864-585-5433
Practice Address - Fax:864-591-4053
Is Sole Proprietor?:No
Enumeration Date:2012-12-21
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC105809163WS0200X
SC22246363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WS0200XNursing Service ProvidersRegistered NurseSchool
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCE4935019OtherMEDICARE PIN
SCNP5743Medicaid
SCSCE4936084OtherMEDICARE PIN
SCSCE493J577OtherMEDICARE PIN