Provider Demographics
NPI:1891357513
Name:FOSTER, VICTORIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 W PEACHTREE ST NW APT 3810
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3444
Mailing Address - Country:US
Mailing Address - Phone:404-641-9969
Mailing Address - Fax:
Practice Address - Street 1:3700 MARKET ST STE E
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-2600
Practice Address - Country:US
Practice Address - Phone:678-383-1383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA092122363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care