Individual
MR. JIMMIE CONSTANTINE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0417
Mailing address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473-9098
(804) 224-7697
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
073861
DC
Other
Enumeration date
11/15/2006
Last updated
02/14/2023
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