Provider Demographics
NPI:1235002189
Name:FOSTER, MARLY KATE
Entity type:Individual
Prefix:
First Name:MARLY
Middle Name:KATE
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 1:1390 DAVIS YANCEY RD
Mailing Address - Street 2:
Mailing Address - City:MICHIE
Mailing Address - State:TN
Mailing Address - Zip Code:38357-6139
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1390 DAVIS YANCEY RD
Practice Address - Street 2:
Practice Address - City:MICHIE
Practice Address - State:TN
Practice Address - Zip Code:38357-6139
Practice Address - Country:US
Practice Address - Phone:662-415-7073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN239959163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse