Individual
MAKENNA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3303 E BASELINE RD., STE 113, QUEEN CREEK, AZ 85142-7444
(480) 369-7161
Mailing address
3303 E BASELINE RD., STE 113, QUEEN CREEK, AZ 85142
(480) 369-7161
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
239699
AZ
Other
Enumeration date
03/30/2020
Last updated
03/30/2020
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