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Individual

DIONNE LASHAWN MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1650 COWLES ST, FAIRBANKS, AK 99701-5907
(907) 459-3540
Mailing address
402 IDITAROD AVE, FAIRBANKS, AK 99701-3732
(702) 755-5019

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
172801
AK
176B00000X
Midwife
11868743-4402
UT
176B00000X
Midwife
Primary
189197
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1821677600
AK
05
1821677600
UT
Enumeration date
04/07/2021
Last updated
04/01/2025
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