Individual
JENNIFER NERISON MONTAGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Contact information
Practice address
41 DONALD B DEAN DR STE A, SOUTH PORTLAND, ME 04106-3252
(207) 661-6064
Mailing address
3 LEEMAN ST, PORTLAND, ME 04103-2420
(406) 471-5403
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86036308
—
133V00000X
Registered Dietitian
DI1603
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86036308
REGISTERED DIETITIAN (CDR)
—
01
—
DI1603
LICENSED DIETITIAN
ME
Enumeration date
06/21/2021
Last updated
06/21/2021
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