Individual
LISA MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 N JUNIATA ST UNIT 53, HAVRE DE GRACE, MD 21078-2964
(443) 804-7407
Mailing address
301 N JUNIATA ST UNIT 53, HAVRE DE GRACE, MD 21078-2964
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R161599
MD
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R161599
MD
Other
Enumeration date
09/15/2010
Last updated
04/23/2026
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