Provider Demographics
NPI:1326233487
Name:FOSTER, LISA JEAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:JEAN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4125 MEDINA ROAD, SUITE 104
Mailing Address - Street 2:THE SURGERY CENTER
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312
Mailing Address - Country:US
Mailing Address - Phone:330-665-8124
Mailing Address - Fax:330-665-8129
Practice Address - Street 1:4125 MEDINA ROAD, SUITE 104
Practice Address - Street 2:THE SURGERY CENTER
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312
Practice Address - Country:US
Practice Address - Phone:330-665-8124
Practice Address - Fax:330-665-8129
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP-08945363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health