Provider Demographics
NPI:1891262028
Name:MONTOYA, SARAH LOUISE
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:LOUISE
Last Name:MONTOYA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9737 WESTBOUND AVE SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-7838
Mailing Address - Country:US
Mailing Address - Phone:505-545-1412
Mailing Address - Fax:
Practice Address - Street 1:9737 WESTBOUND AVE SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-7838
Practice Address - Country:US
Practice Address - Phone:505-545-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist