Provider Demographics
NPI:1720851116
Name:FOSTER, JAMARRAH JANAY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMARRAH
Middle Name:JANAY
Last Name:FOSTER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4567 S WHITNALL AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCIS
Mailing Address - State:WI
Mailing Address - Zip Code:53235-6029
Mailing Address - Country:US
Mailing Address - Phone:262-358-3093
Mailing Address - Fax:
Practice Address - Street 1:2500 W LAYTON AVE STE 120
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-5400
Practice Address - Country:US
Practice Address - Phone:262-297-7246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13929-33207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine