Individual
CAROLYN A MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369-4485
(952) 993-1440
Mailing address
9555 UPLAND LN N, MAPLE GROVE, MN 55369-4485
(952) 993-1440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10000785A
IN
363A00000X
Physician Assistant
Primary
13212
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000367990
BCBS - MARY STREET
IN
01
—
000000381096
BCBS - GATEWAY
IN
05
—
95005716
—
KY
Enumeration date
09/13/2006
Last updated
02/11/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us