Individual
MR. JORDAN DAVID FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
127 ROMANZA LN, PALM DESERT, CA 92211-0777
(517) 256-3944
Mailing address
3108 CANTERBURY BLVD APT 1, FORT WAYNE, IN 46835-3228
(517) 256-3944
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28252823A
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
138955
IN
Other
Enumeration date
05/19/2022
Last updated
08/29/2022
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