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Individual
MRS. PATRICIA MONTGOMERY
Active
Individual
MRS. PATRICIA MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRATITIONER
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
188439
MA
363LF0000X
Family Nurse Practitioner
Primary
RN051705
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
188439
COMMONWEALTH OF MASSACHUS
MA
01
—
RN051705
STATE OF GEORGIA
GA
Enumeration date
07/26/2007
Last updated
07/26/2007
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