Individual
STAECY MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PN
Contact information
Practice address
417 NE COLONIAL CT, LEES SUMMIT, MO 64064-1917
(816) 503-8615
Mailing address
417 NE COLONIAL CT, LEES SUMMIT, MO 64064-1917
(816) 503-8615
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2007029746
MO
Other
Enumeration date
03/31/2008
Last updated
03/31/2008
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