Provider Demographics
NPI:1497771315
Name:FRONTIER NURSING HEALTHCARE
Entity Type:Organization
Organization Name:FRONTIER NURSING HEALTHCARE
Other - Org Name:COMMUNITY HEALTH CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-253-3637
Mailing Address - Street 1:17644 S HWY 421
Mailing Address - Street 2:
Mailing Address - City:BIGCREEK
Mailing Address - State:KY
Mailing Address - Zip Code:40914
Mailing Address - Country:US
Mailing Address - Phone:859-253-3637
Mailing Address - Fax:859-281-6783
Practice Address - Street 1:17644 S HWY 421
Practice Address - Street 2:
Practice Address - City:BIG CREEK
Practice Address - State:KY
Practice Address - Zip Code:40914
Practice Address - Country:US
Practice Address - Phone:606-598-6196
Practice Address - Fax:606-598-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001510Medicaid
7430OtherKY MCR
7430OtherKY MCR