Individual
PORSCHE D. MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
2001 LAUREL ST, COLUMBIA, SC 29204-1018
(843) 792-1414
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3321
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
25455
SC
363LF0000X
Family Nurse Practitioner
Primary
25455
SC
Other
Enumeration date
02/01/2022
Last updated
11/28/2022
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