Provider Demographics
NPI:1316383888
Name:FRONTIER FAMILY PRACTICE LLC
Entity Type:Organization
Organization Name:FRONTIER FAMILY PRACTICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:K
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:715-610-0200
Mailing Address - Street 1:1123 BIG HORN AVE
Mailing Address - Street 2:
Mailing Address - City:WORLAND
Mailing Address - State:WY
Mailing Address - Zip Code:82401-2802
Mailing Address - Country:US
Mailing Address - Phone:715-610-0200
Mailing Address - Fax:
Practice Address - Street 1:1123 BIG HORN AVE
Practice Address - Street 2:
Practice Address - City:WORLAND
Practice Address - State:WY
Practice Address - Zip Code:82401-2802
Practice Address - Country:US
Practice Address - Phone:715-610-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-10
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care