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General NPI Number Information
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NPI Number | 1124235759
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Entity Type | Organization
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Legal Business Name | FRONTIER NEUROSCIENCES, LLC
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 702 PLATINUM DR
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City | CODY
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State | WY
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Zip | 82414-3420
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Country | US
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Telephone | 307-578-1985
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Fax | 307-578-1938
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Provider Business Mailing Address
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Address Line | 702 PLATINUM DR
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City | CODY
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State | WY
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Zip | 82414-3420
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Country | US
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Telephone | 307-578-1985
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Fax | 307-578-1938
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MICHELLE R LEMMON
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Credential |
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Telephone | 307-578-1985
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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