Provider Demographics
NPI:1760766497
Name:MONTI, KIMBERLY M (FNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:MONTI
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 1:52 MDG
Mailing Address - Street 2:UNIT 3690
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09126-3690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 MDG
Practice Address - Street 2:UNIT 3690
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09126
Practice Address - Country:US
Practice Address - Phone:314-452-3498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-29
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 304439163W00000X
OHAPRN.CNP.16753363LF0000X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily