Provider Demographics
NPI:1780877589
Name:FOSTER, DONNA PAULINE (NP)
Entity type:Individual
Prefix:MRS
First Name:DONNA
Middle Name:PAULINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 S PINE ST, JMB, 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274
Mailing Address - Country:US
Mailing Address - Phone:812-524-4265
Mailing Address - Fax:812-524-4269
Practice Address - Street 1:225 S PINE ST, JMB, 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274-2363
Practice Address - Country:US
Practice Address - Phone:812-524-4265
Practice Address - Fax:812-524-4269
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71002436A363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000873389OtherANTHEM
IN200879670Medicaid
IN265740004Medicare PIN