Provider Demographics
NPI:1093764888
Name:JONES, FOSTER DAVID (CRNP)
Entity Type:Individual
Prefix:
First Name:FOSTER
Middle Name:DAVID
Last Name:JONES
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 169
Mailing Address - Street 2:
Mailing Address - City:PARRISH
Mailing Address - State:AL
Mailing Address - Zip Code:35580-0169
Mailing Address - Country:US
Mailing Address - Phone:205-686-5113
Mailing Address - Fax:205-686-5145
Practice Address - Street 1:5947 HWY 269
Practice Address - Street 2:
Practice Address - City:PARRISH
Practice Address - State:AL
Practice Address - Zip Code:35580-0169
Practice Address - Country:US
Practice Address - Phone:205-686-5113
Practice Address - Fax:205-686-5145
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-073567363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALQ50708Medicare UPIN