Basic Information
| Provider Information | |||||||||
| NPI: | 1447631858 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FOSTER | ||||||||
| FirstName: | KRYSTAL | ||||||||
| MiddleName: | ROSE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL DR | ||||||||
| Address2: | MA303, DC032.00 | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652121000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5738842912 | ||||||||
| FaxNumber: | 5738844122 | ||||||||
| Practice Location | |||||||||
| Address1: | 1001 W WORLEY ST | ||||||||
| Address2: | HOME | ||||||||
| City: | COLUMBIA | ||||||||
| State: | MO | ||||||||
| PostalCode: | 652032037 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5732142314 | ||||||||
| FaxNumber: | 5738142784 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2015 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/08/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 2015017101 | MO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2018004599 | MO | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.