Provider Demographics
NPI:1639833221
Name:FOSTER, ANITA
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ANITA
Other - Middle Name:
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:424 US HIGHWAY 45 W
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-8503
Mailing Address - Country:US
Mailing Address - Phone:731-487-1380
Mailing Address - Fax:
Practice Address - Street 1:424 US HIGHWAY 45 W
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-8503
Practice Address - Country:US
Practice Address - Phone:731-420-6393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)