Individual
SUSAN J MONTFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP, FNP-C
Contact information
Practice address
3193 E 1ST ST, VIDALIA, GA 30474-8830
(912) 537-8588
Mailing address
700 MITCHELL DR, VIDALIA, GA 30474-9319
(912) 423-1323
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN146160
GA
363LF0000X
Family Nurse Practitioner
RN149160
GA
Other
Enumeration date
02/17/2020
Last updated
04/04/2025
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