Individual
ELIZABETH ANNE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
210 E GRAY ST, STE 601, LOUISVILLE, KY 40202-3902
(502) 588-3600
(502) 588-9536
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-3600
(502) 588-9536
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
3007751
KY
363LF0000X
Family Nurse Practitioner
Primary
3007751
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201165230
—
IN
05
—
7100223480
—
KY
Enumeration date
10/30/2012
Last updated
01/27/2021
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