Healthcare Provider Details
I. General information
NPI: 1083630909
Provider Name (Legal Business Name): FRONTIER NURSING HEALTHCARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2006
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
96 HWY 80
HYDEN KY
41749-8500
US
IV. Provider business mailing address
96 HWY 80 HURTS CREEK CENTER P.O. BOX 680
HYDEN KY
41749-8500
US
V. Phone/Fax
- Phone: 606-672-1419
- Fax: 606-672-5245
- Phone: 606-672-1102
- Fax: 606-672-3626
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
CONNIE
L.
HUBBARD
Title or Position: RISK MANAGER
Credential:
Phone: 606-672-1102