Provider Demographics
NPI:1578184107
Name:FRONTIER MEDICINE LLC
Entity Type:Organization
Organization Name:FRONTIER MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:AUTHUMN
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANTELLANA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP-FNP-BC
Authorized Official - Phone:970-773-1602
Mailing Address - Street 1:PO BOX 1235
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:CO
Mailing Address - Zip Code:81520-1235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:949-577-4586
Practice Address - Street 1:2472 PATTERSON RD UNIT 5
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-1100
Practice Address - Country:US
Practice Address - Phone:970-773-1602
Practice Address - Fax:949-577-4586
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-05
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty