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General NPI Number Information
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NPI Number | 1295220242
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Entity Type | Organization
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Legal Business Name | FRONTIER BEHAVIORAL HEALTH, LLC
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Dates
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Enumeration Date | 06/22/2018
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Last Update Date | 06/22/2018
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Provider Practice Location Address
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Address Line | 2435 KING BLVD STE 313
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City | CASPER
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State | WY
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Zip | 82604-3169
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Country | US
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Telephone | 307-462-4876
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Fax | 307-337-3492
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Provider Business Mailing Address
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Address Line | 2435 KING BLVD STE 313
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City | CASPER
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State | WY
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Zip | 82604-3169
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Country | US
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Telephone | 307-462-4876
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Fax | 307-337-3492
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | ANGELA NEFF
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Credential | APRN, PMHNP-BC
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Telephone | 307-554-0423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 27393.1195
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License Number State | WY
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