Individual
KIMBERLY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1140 N HUDSON AVE, OKLAHOMA CITY, OK 73103-3918
(405) 858-2978
Mailing address
4436 NW 50TH ST, OKLAHOMA CITY, OK 73112-2212
(405) 858-2716
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
108843
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N/A
N/A
—
Enumeration date
01/02/2015
Last updated
01/02/2015
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