Provider Demographics
NPI:1578723300
Name:MONTGOMERY-SUBER, JANICE M (FNP)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:M
Last Name:MONTGOMERY-SUBER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 KANEOHE BAY DR
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1705
Mailing Address - Country:US
Mailing Address - Phone:808-728-0957
Mailing Address - Fax:
Practice Address - Street 1:6700 KALANIANAOLE HWY STE 201
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96825-1279
Practice Address - Country:US
Practice Address - Phone:080-796-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN45020163W00000X
HIAPRN628363LF0000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily