Provider Demographics
NPI:1194837187
Name:FOSTER, SHERRY K
Entity Type:Individual
Prefix:MS
First Name:SHERRY
Middle Name:K
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:RT.3 BOX 17
Mailing Address - Street 2:
Mailing Address - City:ELLINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63638
Mailing Address - Country:US
Mailing Address - Phone:573-663-2724
Mailing Address - Fax:
Practice Address - Street 1:209 MAIN ST.
Practice Address - Street 2:
Practice Address - City:EMINENCE
Practice Address - State:MO
Practice Address - Zip Code:65466
Practice Address - Country:US
Practice Address - Phone:573-226-5505
Practice Address - Fax:573-226-5584
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO046255164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse