Provider Demographics
NPI:1346333986
Name:MONTEILH, CARIDAD M (FNP-C)
Entity Type:Individual
Prefix:
First Name:CARIDAD
Middle Name:M
Last Name:MONTEILH
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3778 HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:LOCUST GROVE
Mailing Address - State:GA
Mailing Address - Zip Code:30248-3632
Mailing Address - Country:US
Mailing Address - Phone:678-610-6649
Mailing Address - Fax:678-610-6025
Practice Address - Street 1:3778 HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3632
Practice Address - Country:US
Practice Address - Phone:678-610-6649
Practice Address - Fax:678-610-6025
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA154006363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily