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Individual

ROBERTA J MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1401381
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0107835
MEDICA
MN
01
1022855
PREFERRED ONE
MN
01
140897D277
UCARE
MN
01
51G60MO
BLUE SHIELD
MN
05
731528700
MN
01
857963
AMERICA'S PPO
MN
01
A020
CHAMPUS
MN
01
HP34223
HEALTH PARTNERS
MN
Enumeration date
01/27/2006
Last updated
04/04/2025
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