Provider Demographics
NPI:1578665402
Name:FOSTER, BONNIE E (CPNP)
Entity type:Individual
Prefix:
First Name:BONNIE
Middle Name:E
Last Name:FOSTER
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 AIRPORT HEIGHTS DR STE 140
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2970
Mailing Address - Country:US
Mailing Address - Phone:907-777-1800
Mailing Address - Fax:907-278-2066
Practice Address - Street 1:1200 AIRPORT HEIGHTS DR STE 140
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2970
Practice Address - Country:US
Practice Address - Phone:907-777-1800
Practice Address - Fax:907-278-2066
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK821363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKNP9508Medicaid