Provider Demographics
NPI:1316223332
Name:MONTGOMERY, PATRICIA RENAE (RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:RENAE
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6921 BRISBANE CT # 260
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7094
Mailing Address - Country:US
Mailing Address - Phone:281-816-5111
Mailing Address - Fax:281-697-4301
Practice Address - Street 1:6921 BRISBANE CT # 260
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7094
Practice Address - Country:US
Practice Address - Phone:281-816-5111
Practice Address - Fax:281-697-4301
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28253716A163W00000X, 363LF0000X
MARN2370497163W00000X, 363LF0000X
IL041346711163W00000X
TX1082109163W00000X, 363LF0000X
IL209009210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse