Healthcare Provider Details

I. General information

NPI: 1174549091
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: 03/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 KATE IRELAND DR
HYDEN KY
41749
US

IV. Provider business mailing address

130 KATE IRELAND DR
HYDEN KY
41749-8500
US

V. Phone/Fax

Practice location:
  • Phone: 606-672-2113
  • Fax: 606-672-2117
Mailing address:
  • Phone: 606-672-1102
  • Fax: 606-672-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily 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