Basic Information
| Provider Information | |||||||||
| NPI: | 1164496444 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOSTER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | BURLEIGH | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RN, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9202 N 47TH DR | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853023603 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6239806764 | ||||||||
| FaxNumber: | 7572990453 | ||||||||
| Practice Location | |||||||||
| Address1: | 1209 S 1ST AVE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850032605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022586797 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2006 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 370 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | RN084673 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.