Individual
KENT MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
321 EAST MAIN STREET, MOREHEAD, KY 40351
(606) 784-4161
(606) 783-9952
Mailing address
P O BOX 790, ASHLAND, KY 41105-0790
(606) 329-8588
(606) 329-8195
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1070170
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347212 NONPAR
ANTHEM BCBS
—
05
—
30610026
—
KY
Enumeration date
10/03/2006
Last updated
09/07/2011
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