Individual
MR. NATHAN KANE FOSMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
US DEPT OF THE US AIRFORCE, 690 BARNES BLVD, MCCHORD AFB, WA 98438
(509) 982-0328
Mailing address
3020 OAK ST SW, MCCHORD AFB, WA 98439-1713
(509) 869-9567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN00159938
WA
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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