Provider Demographics
NPI:1124406491
Name:FOSTER, YVONNEJOYCE CRYVONNE
Entity Type:Individual
Prefix:MRS
First Name:YVONNEJOYCE
Middle Name:CRYVONNE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 E 39TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-3021
Mailing Address - Country:US
Mailing Address - Phone:216-203-9354
Mailing Address - Fax:
Practice Address - Street 1:2210 E 39TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3021
Practice Address - Country:US
Practice Address - Phone:216-203-9354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.156241-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse