Individual
KERI H MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3900 WASHINGTON AVE, STE 100, EVANSVILLE, IN 47714-0550
(812) 485-6694
(812) 485-7678
Mailing address
3900 WASHINGTON AVE # 100, EVANSVILLE, IN 47714-0550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
71005783A
IN
363LP0200X
Pediatric Nurse Practitioner
Primary
71005783A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201324670
—
IN
Enumeration date
09/17/2014
Last updated
07/17/2024
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