Individual
DIANA MICHELLE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
305 W. MAIN STREET, NEA BAPTIST CLINIC, TRUMANN, AR 72472
(870) 483-6131
(870) 483-2573
Mailing address
PO BOX 1960, NEA BAPTIST CLINIC, JONESBORO, AR 72403-1960
(870) 483-6131
(870) 483-2573
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
A01699
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150983758
—
AR
Enumeration date
06/16/2005
Last updated
02/17/2016
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