Provider Demographics
NPI:1467748764
Name:FOSTER, ANN MICHELLE (LICENSED PRACTICAL N)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:MICHELLE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:LICENSED PRACTICAL N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23999 NORTHWESTERN HWY
Mailing Address - Street 2:#200
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2578
Mailing Address - Country:US
Mailing Address - Phone:248-569-1040
Mailing Address - Fax:
Practice Address - Street 1:23999 NORTHWESTERN HWY
Practice Address - Street 2:#200
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2578
Practice Address - Country:US
Practice Address - Phone:248-569-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703084835164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse