Provider Demographics
NPI:1174847313
Name:FOSTER, ANGELA D (APN)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:D
Last Name:FOSTER
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:587 HIGHWAY 365
Mailing Address - Street 2:PO BOX 925
Mailing Address - City:MAYFLOWER
Mailing Address - State:AR
Mailing Address - Zip Code:72106-9570
Mailing Address - Country:US
Mailing Address - Phone:501-470-7413
Mailing Address - Fax:501-470-7415
Practice Address - Street 1:587 HIGHWAY 365
Practice Address - Street 2:
Practice Address - City:MAYFLOWER
Practice Address - State:AR
Practice Address - Zip Code:72106-9570
Practice Address - Country:US
Practice Address - Phone:501-470-7413
Practice Address - Fax:501-470-7415
Is Sole Proprietor?:No
Enumeration Date:2010-03-17
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03345 APN363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily