Provider Demographics
NPI:1487943486
Name:FOSTER, RENEE REINE (APRN, FNP, PMHNP,DNP)
Entity type:Individual
Prefix:DR
First Name:RENEE
Middle Name:REINE
Last Name:FOSTER
Suffix:
Gender:F
Credentials:APRN, FNP, PMHNP,DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91-1300 KAIKOHOLA ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-6260
Mailing Address - Country:US
Mailing Address - Phone:808-679-2680
Mailing Address - Fax:
Practice Address - Street 1:1164 BISHOP ST STE 1611
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2816
Practice Address - Country:US
Practice Address - Phone:808-261-7792
Practice Address - Fax:808-792-0034
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-31
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI1565363LF0000X, 363LP0808X
LAAP06252363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2147439Medicaid