Provider Demographics
NPI:1922743459
Name:FOSTER, CHEVON ALISA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:CHEVON
Middle Name:ALISA
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 1:28 E 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-6204
Mailing Address - Country:US
Mailing Address - Phone:609-238-2320
Mailing Address - Fax:
Practice Address - Street 1:28 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:PINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:08021-6204
Practice Address - Country:US
Practice Address - Phone:609-238-2320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-29
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP023811363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care