Provider Demographics
NPI:1295825289
Name:MONTANO, MARY JANE LOPEZ (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY JANE
Middle Name:LOPEZ
Last Name:MONTANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CMR 464 BOX 2975
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09226
Mailing Address - Country:DE
Mailing Address - Phone:09721-476-3439
Mailing Address - Fax:
Practice Address - Street 1:US ARMY HEALTH CLINIC SCHWEINFURT
Practice Address - Street 2:CMR 457
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09033
Practice Address - Country:DE
Practice Address - Phone:011499721-476-3439
Practice Address - Fax:011499-721-6872
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172933163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care