Provider Demographics
NPI:1467432492
Name:FROEMKE, HEIDI A (FNP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:A
Last Name:FROEMKE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 KATE IRELAND DR
Mailing Address - Street 2:
Mailing Address - City:HYDEN
Mailing Address - State:KY
Mailing Address - Zip Code:41749
Mailing Address - Country:US
Mailing Address - Phone:606-672-2901
Mailing Address - Fax:606-672-3626
Practice Address - Street 1:130 KATE IRELAND DR
Practice Address - Street 2:
Practice Address - City:HYDEN
Practice Address - State:KY
Practice Address - Zip Code:41749
Practice Address - Country:US
Practice Address - Phone:606-672-2901
Practice Address - Fax:606-672-3626
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1933P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78007184Medicaid
R78644Medicare UPIN