Provider Demographics
NPI:1922542893
Name:MONTANO, GENEVA (CPM)
Entity Type:Individual
Prefix:
First Name:GENEVA
Middle Name:
Last Name:MONTANO
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3788 S HAZEL CT
Mailing Address - Street 2:
Mailing Address - City:SHERIDAN
Mailing Address - State:CO
Mailing Address - Zip Code:80110-3222
Mailing Address - Country:US
Mailing Address - Phone:720-422-4214
Mailing Address - Fax:
Practice Address - Street 1:3788 S HAZEL CT
Practice Address - Street 2:
Practice Address - City:SHERIDAN
Practice Address - State:CO
Practice Address - Zip Code:80110-3222
Practice Address - Country:US
Practice Address - Phone:720-422-4214
Practice Address - Fax:720-528-8063
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-13
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO169176B00000X
COMWR0000169176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife