Individual
KELLY NICOLE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3591 RESERVE COMMONS DR STE 100, MEDINA, OH 44256-5334
(216) 450-1613
(216) 450-1614
Mailing address
25700 SCIENCE PARK DR STE 210, BEACHWOOD, OH 44122-7328
(216) 450-1613
(216) 450-1614
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN.CNP.0028297
OH
363LF0000X
Family Nurse Practitioner
APRN.CNP.0028297
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN.CNP.0028297
OH
Other
Enumeration date
01/22/2021
Last updated
02/23/2021
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