Individual
CHRISTINE MONTANARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 BROADWAY, FORT WAYNE, IN 46802-1402
(260) 344-4035
(260) 969-9272
Mailing address
6435 W JEFFERSON BLVD, PMB 109, FORT WAYNE, IN 46804-6203
(260) 344-4035
(260) 969-9272
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28225101A
IN
363LA2200X
Adult Health Nurse Practitioner
Primary
71005710A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0150229
—
OH
05
—
201315480
—
IN
Enumeration date
08/28/2015
Last updated
06/20/2016
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