Provider Demographics
NPI:1639497795
Name:FOSTER, ANNA E (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:E
Last Name:FOSTER
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7267 JESSMAN ROAD WEST DR APT D
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46256-4193
Mailing Address - Country:US
Mailing Address - Phone:765-760-1501
Mailing Address - Fax:
Practice Address - Street 1:5000 NOWLAND AVE
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201-1836
Practice Address - Country:US
Practice Address - Phone:317-356-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36001332A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer