Individual
ISMARI MONTANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
362 CALLEN LN NW, SUITE 110, CLEVELAND, TN 37312-3784
(423) 331-5025
(423) 698-0511
Mailing address
PO BOX 2072, COLLEGEDALE, TN 37315-2072
(423) 227-8955
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN0000147736
TN
363L00000X
Nurse Practitioner
Primary
22663
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q029115
—
TN
Enumeration date
03/28/2007
Last updated
08/29/2022
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