Provider Demographics
NPI:1144708728
Name:FOSTER, TEAL J (NP-C)
Entity type:Individual
Prefix:DR
First Name:TEAL
Middle Name:J
Last Name:FOSTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:TEAL
Other - Middle Name:J
Other - Last Name:TRNKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:275 3RD ST S STE 302
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55082-8001
Mailing Address - Country:US
Mailing Address - Phone:651-309-4300
Mailing Address - Fax:
Practice Address - Street 1:275 3RD ST S STE 302
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-8001
Practice Address - Country:US
Practice Address - Phone:651-309-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-05
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily