Provider Demographics
NPI:1083630909
Name:FRONTIER NURSING HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FRONTIER NURSING HEALTHCARE, INC.
Other - Org Name:CHRISTIAN FAMILY HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:RISK MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-672-1102
Mailing Address - Street 1:96 HWY 80 HURTS CREEK CENTER
Mailing Address - Street 2:P.O. BOX 680
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749-8500
Mailing Address - Country:US
Mailing Address - Phone:606-672-1102
Mailing Address - Fax:606-672-3626
Practice Address - Street 1:96 HWY 80
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749-8500
Practice Address - Country:US
Practice Address - Phone:606-672-1419
Practice Address - Fax:606-672-5245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001874Medicaid
9615OtherKY MCR
KY35001874Medicaid