Provider Demographics
NPI:1013023373
Name:FOSTER, PEGGY (CNS)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4449 STATE ROUTE 159
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-8620
Mailing Address - Country:US
Mailing Address - Phone:740-775-1260
Mailing Address - Fax:740-773-1264
Practice Address - Street 1:4449 STATE ROUTE 159
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8620
Practice Address - Country:US
Practice Address - Phone:740-775-1260
Practice Address - Fax:740-773-1264
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNS03265364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHNS04751Medicare PIN
OHNS04754Medicare PIN
OHF02022781Medicare ID - Type Unspecified
OHNS04756Medicare PIN
OHNS04752Medicare PIN
OHNS04755Medicare PIN
OHNS04753Medicare PIN