Provider Demographics
NPI:1578672697
Name:FOSTER, LAURA ANN (APRN)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:ANN
Last Name:FOSTER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 530062
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-0062
Mailing Address - Country:US
Mailing Address - Phone:843-695-6071
Mailing Address - Fax:843-569-5879
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 202
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9155
Practice Address - Country:US
Practice Address - Phone:843-572-1200
Practice Address - Fax:843-553-0424
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2021-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005683B363LF0000X
SC18719363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP2723Medicaid
SCSC30527555Medicare PIN
SCSC30525281Medicare PIN
SCSC30526868Medicare PIN
SCSC30527498Medicare PIN
SCSC30527499Medicare PIN
SCSC30526882Medicare PIN
SCSC30526834Medicare PIN
SCSC30527006Medicare PIN
SCSC30527126Medicare PIN
SCSC30527522Medicare PIN
SCSC30525282Medicare PIN
SCSC30527819Medicare PIN
SCSC30528798Medicare PIN
SCSC30525277Medicare PIN