Provider Demographics
NPI:1275293235
Name:FOSTER, KATRINA P
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:P
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 1:1590 FOUNTAIN SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-4600
Mailing Address - Country:US
Mailing Address - Phone:330-506-4525
Mailing Address - Fax:
Practice Address - Street 1:1590 FOUNTAIN SQUARE DR
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-4600
Practice Address - Country:US
Practice Address - Phone:330-506-4525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide