Healthcare Provider Details

I. General information

NPI: 1124235759
Provider Name (Legal Business Name): FRONTIER NEUROSCIENCES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 PLATINUM DR
CODY WY
82414-3420
US

IV. Provider business mailing address

702 PLATINUM DR
CODY WY
82414-3420
US

V. Phone/Fax

Practice location:
  • Phone: 307-578-1985
  • Fax: 307-578-1938
Mailing address:
  • Phone: 307-578-1985
  • Fax: 307-578-1938

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE R LEMMON
Title or Position: OFFICE MANAGER
Credential:
Phone: 307-578-1985