Provider Demographics
NPI:1679076616
Name:MONTOYA, SAYWARD ROSE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:SAYWARD
Middle Name:ROSE
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SAYWARD
Other - Middle Name:ROSE
Other - Last Name:DRISCOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5500 MARYLAND WAY STE 400
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-7048
Mailing Address - Country:US
Mailing Address - Phone:844-407-7447
Mailing Address - Fax:
Practice Address - Street 1:1000 E HANES MILL RD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-1384
Practice Address - Country:US
Practice Address - Phone:336-519-6456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-15
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily