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Individual

LATOYA VENISE MONTFORT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ACAGNP

Contact information

Practice address
250 SCENIC HWY, LAWRENCEVILLE, GA 30046-5675
(678) 442-5800
Mailing address
2162 BOULDER GATE DR, ELLENWOOD, GA 30294-1682
(678) 536-8756

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN208269
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
RN208269
GA

Other

Enumeration date
03/24/2020
Last updated
10/15/2025
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