Provider Demographics
NPI:1114938305
Name:MONTEY, KATHLEEN ANN (LPN RCS)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:ANN
Last Name:MONTEY
Suffix:
Gender:F
Credentials:LPN RCS
Other - Prefix:MS
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:ANDREW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:208 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ROSENDALE
Mailing Address - State:WI
Mailing Address - Zip Code:54974
Mailing Address - Country:US
Mailing Address - Phone:920-872-2451
Mailing Address - Fax:
Practice Address - Street 1:148 WHITE ST
Practice Address - Street 2:
Practice Address - City:OAKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53065
Practice Address - Country:US
Practice Address - Phone:920-583-4420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7510031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse