Individual
KASSIE MAXINE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-6652
Mailing address
828 N BROADWAY APT 526, DENVER, CO 80203-2792
(443) 668-3530
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
APN.0994369-NP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RXN.0103715-NP
COLORADO DEPARTMENT OF REGULATORY AGENCIES DIVISION OF PROFESSIONS AND OCCUPATIO
CO
Enumeration date
01/07/2019
Last updated
01/07/2019
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