MEDICARE: FRONTIER FAMILY PRACTICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1700144268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FRONTIER FAMILY PRACTICE

Provider Business Mailing Address
First Line	:	PO BOX 37
Second Line	:
City	:	FAIRFIELD
State	:	MT
Zip	:	59436-0037
Country	:	US
Telephone Number	:	406-622-3357
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 1ST AVE NORTH
Second Line	:
City	:	FAIRFIELD
State	:	MT
Zip	:	59436-0037
Country	:	US
Telephone Number	:	406-622-3357
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER/FNP
Name	:	VALERIE ANDERSON
Credential	:	FNP
Telephone Number	:	406-467-3447

Provider Enumeration Date	:	05/02/2012
Last Update Date	:	09/25/2013

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Directions to “FRONTIER FAMILY PRACTICE ” Practice Location

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