Individual
MARISA M MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2604 MEDICAL OFFICE PL OFC PL, GOLDSBORO, NC 27534-9417
(919) 580-0004
(919) 580-9099
Mailing address
2604 MEDICAL OFFICE PL, GOLDSBORO, NC 27534-9417
(919) 580-0004
(919) 580-9099
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5007175
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10038532
NC MEDICAL LIC
NC
Enumeration date
09/19/2014
Last updated
06/05/2024
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