Provider Demographics
NPI:1942927827
Name:FOSTER, DAKOTA SKYYE
Entity Type:Individual
Prefix:
First Name:DAKOTA
Middle Name:SKYYE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46615-2214
Mailing Address - Country:US
Mailing Address - Phone:574-354-9838
Mailing Address - Fax:
Practice Address - Street 1:706 S 27TH ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615-2214
Practice Address - Country:US
Practice Address - Phone:574-354-9838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-21
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174N00000XOther Service ProvidersLactation Consultant, Non-RN