Provider Demographics
NPI:1881317279
Name:FOTHERINGHAM, TRICIA (BSN, RN, NCSN)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:
Last Name:FOTHERINGHAM
Suffix:
Gender:F
Credentials:BSN, RN, NCSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3194 S EDISON CT
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2715
Mailing Address - Country:US
Mailing Address - Phone:509-378-4277
Mailing Address - Fax:
Practice Address - Street 1:301 N 10TH AVE
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-5480
Practice Address - Country:US
Practice Address - Phone:509-547-2429
Practice Address - Fax:509-543-6793
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00122591163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool