Provider Demographics
NPI:1912448044
Name:FOSTER, ANNA (IBCLC, OTR/L)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:IBCLC, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 KATHY CIR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-4402
Mailing Address - Country:US
Mailing Address - Phone:949-463-2330
Mailing Address - Fax:
Practice Address - Street 1:1330 OAKRIDGE DR UNIT 105
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-9651
Practice Address - Country:US
Practice Address - Phone:970-460-6762
Practice Address - Fax:970-680-7250
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174N00000X
WYOT-1248225X00000X
LA328491225X00000X
COOT.0008845225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No174N00000XOther Service ProvidersLactation Consultant, Non-RN