Provider Demographics
NPI:1679049985
Name:FOSTER, JOANN M
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:M
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:M
Other - Last Name:DINING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:409 BELL RD S
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-3864
Mailing Address - Country:US
Mailing Address - Phone:315-338-5274
Mailing Address - Fax:
Practice Address - Street 1:409 BELL RD S
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-3864
Practice Address - Country:US
Practice Address - Phone:315-338-5274
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY701327163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool