Provider Demographics
NPI:1245571066
Name:MONTGOMERY, BRITTANY NICOLE (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BRITTANY
Middle Name:NICOLE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 WESTGATE CIR
Mailing Address - Street 2:BOX 100
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8395
Mailing Address - Country:US
Mailing Address - Phone:615-678-0024
Mailing Address - Fax:
Practice Address - Street 1:1605 WESTGATE CIR
Practice Address - Street 2:BOX 100
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8395
Practice Address - Country:US
Practice Address - Phone:615-678-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-122149363LA2200X
TN22395363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health