Individual
MRS. SHANNON MICHELLE MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
6360 S 3000 E, 210, SALT LAKE CITY, UT 84121-6923
(435) 615-8822
Mailing address
6360 S 3000 E, 210, SALT LAKE CITY, UT 84121-6923
(435) 615-8822
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
345074-4405
UT
Other
Enumeration date
12/15/2015
Last updated
12/15/2015
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