Provider Demographics
NPI:1497194146
Name:MONTJOY, MARIE NICHOLE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:NICHOLE
Last Name:MONTJOY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2245
Mailing Address - Country:US
Mailing Address - Phone:614-725-3740
Mailing Address - Fax:
Practice Address - Street 1:590 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2245
Practice Address - Country:US
Practice Address - Phone:614-725-3740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH151059164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse