Provider Demographics
NPI:1114597036
Name:FOSTER, SEPTEMBER DAWN (RN)
Entity Type:Individual
Prefix:
First Name:SEPTEMBER
Middle Name:DAWN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:710 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:FERDINAND
Mailing Address - State:IN
Mailing Address - Zip Code:47532-9020
Mailing Address - Country:US
Mailing Address - Phone:812-504-2578
Mailing Address - Fax:
Practice Address - Street 1:710 SUNRISE DR
Practice Address - Street 2:
Practice Address - City:FERDINAND
Practice Address - State:IN
Practice Address - Zip Code:47532-9020
Practice Address - Country:US
Practice Address - Phone:812-504-2578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28185452A163WA2000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator