Individual
DENISE L. MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
14700 LAKE SHORE DR, CHARLEVOIX, MI 49720-1999
(231) 547-4024
Mailing address
14700 LAKE SHORE DR, CHARLEVOIX, MI 49720-1999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-250616
OH
367500000X
Certified Registered Nurse Anesthetist
Primary
4704272096
MI
Other
Enumeration date
11/08/2008
Last updated
12/21/2022
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