Provider Demographics
NPI:1164726279
Name:FOSTER, JESSICA D (PA)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:D
Last Name:FOSTER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 659506
Mailing Address - Street 2:SECTION 4142
Mailing Address - City:SAN ANTIONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78265-9506
Mailing Address - Country:US
Mailing Address - Phone:405-869-7700
Mailing Address - Fax:405-869-7724
Practice Address - Street 1:1636 MIDTOWN PL
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6347
Practice Address - Country:US
Practice Address - Phone:405-869-7700
Practice Address - Fax:405-869-7724
Is Sole Proprietor?:No
Enumeration Date:2011-01-04
Last Update Date:2020-01-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical