Provider Demographics
NPI:1851436851
Name:FOSTER, CAROLE A (CNP, CNS-PSYCH)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:A
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CNP, CNS-PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 N VANDEMARK RD
Mailing Address - Street 2:SAMARITAN BEHAVIORAL HEALTH, INC.
Mailing Address - City:SIDNEY
Mailing Address - State:OH
Mailing Address - Zip Code:45365-3567
Mailing Address - Country:US
Mailing Address - Phone:937-492-8080
Mailing Address - Fax:937-492-2533
Practice Address - Street 1:601 S EDWIN C MOSES BLVD
Practice Address - Street 2:SAMARITAN BEHAVIORAL HEALTH, INC.
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-3424
Practice Address - Country:US
Practice Address - Phone:419-229-2222
Practice Address - Fax:419-225-7634
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2016-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN206637363LP0808X
OHCOA.04855-NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNP12562Medicare ID - Type UnspecifiedMEDICARE NUMBER
OHH185911Medicare PIN