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Individual

MRS. CALLIE DARLENE MONTGOMERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
105 W STONE DR STE 3A, KINGSPORT, TN 37660-3365
(423) 392-6200
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN0000014405
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1517292
TN
Enumeration date
09/15/2009
Last updated
06/02/2023
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