Individual
KELLY M MONTAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
6402-33
WI
367500000X
Certified Registered Nurse Anesthetist
D188460
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174904528
—
WI
Enumeration date
06/11/2015
Last updated
02/26/2026
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