1407851611 NPI number — KAREN FOSTER-ANDERSON CNM

Table of content: KAREN FOSTER-ANDERSON CNM (NPI 1407851611)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407851611 NPI number — KAREN FOSTER-ANDERSON CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOSTER-ANDERSON
Provider First Name:
KAREN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407851611
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
224-D CORNWALL ST., NW, SUITE 403
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEESBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
20176-2704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-737-6010
Provider Business Mailing Address Fax Number:
703-443-8643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
24430 STONE SPRINGS BLVD., SUITE 550
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DULLES
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20166
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-957-1246
Provider Business Practice Location Address Fax Number:
703-665-2374
Provider Enumeration Date:
06/15/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 176B00000X , with the licence number:  097 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 0024090593 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1407851611 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".