Basic Information
| Provider Information | |||||||||
| NPI: | 1720328834 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FOUST | ||||||||
| FirstName: | TERRAIN | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 15070 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852675070 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4804219700 | ||||||||
| FaxNumber: | 4804219899 | ||||||||
| Practice Location | |||||||||
| Address1: | 5030 S MILL AVE | ||||||||
| Address2: | SUITE D12 | ||||||||
| City: | TEMPE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852826833 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4808942823 | ||||||||
| FaxNumber: | 4807566663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2013 | ||||||||
| LastUpdateDate: | 08/21/2014 | ||||||||
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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 | 363LF0000X | AP4806 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.