Provider Demographics
NPI:1689012965
Name:FOSTER, TRACY K (APRN)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:K
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 1:2693 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-1624
Mailing Address - Country:US
Mailing Address - Phone:409-832-8862
Mailing Address - Fax:409-832-1664
Practice Address - Street 1:2693 NORTH ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-1624
Practice Address - Country:US
Practice Address - Phone:409-832-8862
Practice Address - Fax:409-832-1664
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584745363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX317329YLESMedicare PIN