Individual
MS. HEATHER JEAN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P
Contact information
Practice address
130 HOSPITAL RD 200, PRINCE FREDERICK, MD 20678-4055
(410) 535-4561
(410) 535-9941
Mailing address
130 HOSPITAL RD 200, PRINCE FREDERICK, MD 20678-4055
(410) 535-4561
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R137571
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
120363
JHHC PROVIDER NUMBER
MD
05
—
400427200
—
MD
01
—
61760401
CAREFIRST MD RENDERING
MD
01
—
7605-0058
CAREFIRST BLUECHOICE
MD
01
—
R137571
MHIP PROVIDER ID
MD
Enumeration date
08/10/2005
Last updated
12/02/2025
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