Most Relevant Information
Provider Data
| NPI Number: | 1003404831 |
| Provider Name: | GARY CLINTON FOSTER AGACNP-BC |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2100X |
| Specialty: | Nurse Practitioner |
| License Number: | 28915 |
Most Important Dates
| Enumeration Date: | 01/07/2021 |
| Last Updated: | 01/07/2021 |
Provider Practice Location
551 STELLA RUTH RD
MARTIN
TN
382378503
Practice Location Phone/Fax
| Phone: | 7317965900 |
| Fax: |
Provider Mailing Location
551 STELLA RUTH RD
MARTIN
TN
382378503
Provider Mailing Phone/Fax
| Phone: | 7317965900 |
| Fax: |