Provider Demographics
NPI:1558675199
Name:MONTGOMERY, LISA K (APRN)
Entity Type:Individual
Prefix:MRS
First Name:LISA
Middle Name:K
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:K
Other - Last Name:STEINKRAUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NE
Mailing Address - Zip Code:68769-0489
Mailing Address - Country:US
Mailing Address - Phone:402-582-4245
Mailing Address - Fax:402-582-3940
Practice Address - Street 1:704 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NE
Practice Address - Zip Code:68769-2047
Practice Address - Country:US
Practice Address - Phone:402-582-4245
Practice Address - Fax:402-582-3940
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily