Provider Demographics
NPI:1700511177
Name:FOSTER-HAIRE, DANA DIANE
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:DIANE
Last Name:FOSTER-HAIRE
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 1:11656 BOX ELDER WAY
Mailing Address - Street 2:
Mailing Address - City:VANCE
Mailing Address - State:AL
Mailing Address - Zip Code:35490-2637
Mailing Address - Country:US
Mailing Address - Phone:205-609-8880
Mailing Address - Fax:
Practice Address - Street 1:11656 BOX ELDER WAY
Practice Address - Street 2:
Practice Address - City:VANCE
Practice Address - State:AL
Practice Address - Zip Code:35490-2637
Practice Address - Country:US
Practice Address - Phone:205-652-5529
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program