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General NPI Number Information
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NPI Number | 1598468449
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Entity Type | Organization
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Legal Business Name | FRONTIER PEDIATRIC CARE LLC
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Dates
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Enumeration Date | 03/22/2023
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 8333 GLYNOAKS DR STE 180
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City | LINCOLN
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State | NE
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Zip | 68516-6378
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Country | US
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Telephone | 402-817-2116
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Fax | 402-322-8079
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Provider Business Mailing Address
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Address Line | 8333 GLYNOAKS DR STE 180
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City | LINCOLN
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State | NE
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Zip | 68516-6378
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Country | US
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Telephone | 402-817-2116
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Fax | 402-322-8079
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | COREN FIELDER
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Credential |
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Telephone | 402-817-2116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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