Provider Demographics
NPI:1093842932
Name:MONTOYA, MARGIE (RN, CNP)
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 PLAZA BLANCA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-5341
Mailing Address - Country:US
Mailing Address - Phone:505-476-8875
Mailing Address - Fax:505-476-8898
Practice Address - Street 1:605 LETRADO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4146
Practice Address - Country:US
Practice Address - Phone:505-476-2600
Practice Address - Fax:505-476-2692
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR26268363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health