Individual
CHERYL L MONTAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APNP
Contact information
Practice address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Mailing address
1506 S ONEIDA ST, APPLETON, WI 54915-1305
(920) 738-2000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6075-33
WI
363LA2200X
Adult Health Nurse Practitioner
6075-33
WI
363LG0600X
Gerontology Nurse Practitioner
6075-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135602
RN LIC
WI
01
—
6075
APNP LIC
WI
Enumeration date
10/15/2014
Last updated
04/23/2015
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