Provider Demographics
NPI:1790047017
Name:MONTGOMERY, RHONDA LEA (MSN, APN)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:LEA
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MSN, APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1581 CALDWELL CORNER RD
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:DE
Mailing Address - Zip Code:19734-9258
Mailing Address - Country:US
Mailing Address - Phone:302-750-7553
Mailing Address - Fax:
Practice Address - Street 1:1581 CALDWELL CORNER RD
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:DE
Practice Address - Zip Code:19734-9258
Practice Address - Country:US
Practice Address - Phone:302-750-7553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELT-0000103364SC1501X, 364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No364SC1501XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCommunity Health/Public Health