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Individual
ERIN MONTGOMERY
Active
Individual
ERIN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
2000
WI
363AS0400X
Surgical Physician Assistant
Primary
PA155264
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42886900
—
WI
Enumeration date
07/31/2006
Last updated
10/31/2014
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