Individual
RENA D MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
125 GUTHRIE DR, SOUTHAVEN, MS 38671-5829
(901) 252-3400
(901) 763-4305
Mailing address
1325 WOLF PARK DR, STE 103, GERMANTOWN, TN 38138-1759
(901) 252-3400
(901) 763-4305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN14046
TN
364SW0102X
Women's Health Clinical Nurse Specialist
APN14046
TN
Other
Enumeration date
05/26/2009
Last updated
12/03/2020
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