Provider Demographics
NPI:1598894610
Name:FOSTER, ALISON CORINNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:CORINNE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:CORINNE
Other - Last Name:BRAZEAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2912 CEDARIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-1422
Mailing Address - Country:US
Mailing Address - Phone:813-340-5615
Mailing Address - Fax:
Practice Address - Street 1:3903 NORTHDALE BLVD STE 100E
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33624-1862
Practice Address - Country:US
Practice Address - Phone:813-998-5582
Practice Address - Fax:949-660-5017
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3312652363LA2200X
FL3312652363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health