Provider Demographics
NPI:1669183992
Name:FOSTER, JUSTIN STEPHEN
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:STEPHEN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3232 LINCOYA CREEK DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-2782
Mailing Address - Country:US
Mailing Address - Phone:936-828-8286
Mailing Address - Fax:
Practice Address - Street 1:3232 LINCOYA CREEK DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37214-2782
Practice Address - Country:US
Practice Address - Phone:936-828-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)