Provider Demographics
NPI:1437374741
Name:FOSTER, KATRINA M
Entity Type:Individual
Prefix:
First Name:KATRINA
Middle Name:M
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 1:8805 NW 121ST TER
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1839
Mailing Address - Country:US
Mailing Address - Phone:405-722-1967
Mailing Address - Fax:
Practice Address - Street 1:8805 NW 121ST TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-1839
Practice Address - Country:US
Practice Address - Phone:405-722-1967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver