Basic Information
Provider Information
NPI: 1699227272
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLEY
FirstName: JOSTEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 10100
Address2:  
City: DELTA
State: CO
PostalCode: 814160008
CountryCode: US
TelephoneNumber: 9708747681
FaxNumber: 9708746400
Practice Location
Address1: 1501 E 3RD ST
Address2:  
City: DELTA
State: CO
PostalCode: 814162815
CountryCode: US
TelephoneNumber: 9708747681
FaxNumber: 9708746400
Other Information
ProviderEnumerationDate: 10/28/2016
LastUpdateDate: 02/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XAPN.0993694-CRNACOY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home