Provider Demographics
NPI:1689690505
Name:FRONTIER NURSING HEALTHCARE, INC.
Entity Type:Organization
Organization Name:FRONTIER NURSING HEALTHCARE, INC.
Other - Org Name:KATE IRELAND RHC
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 1:247 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:KY
Mailing Address - Zip Code:40962-1214
Mailing Address - Country:US
Mailing Address - Phone:606-672-1102
Mailing Address - Fax:606-672-3626
Practice Address - Street 1:247 WHITE ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40962
Practice Address - Country:US
Practice Address - Phone:606-599-8297
Practice Address - Fax:606-299-8568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY35001536Medicaid
KY7434OtherKY MCR GROUP
KY35001536Medicaid