Provider Demographics
NPI:1831336882
Name:MONTGOMERY, NANCY (RN, MSN)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11110 ALONDRA BLVD
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-6203
Mailing Address - Country:US
Mailing Address - Phone:562-860-2451
Mailing Address - Fax:562-467-5076
Practice Address - Street 1:11110 ALONDRA BLVD
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CA
Practice Address - Zip Code:90650-6203
Practice Address - Country:US
Practice Address - Phone:562-860-2451
Practice Address - Fax:562-467-5076
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA451509163WC1400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1400XNursing Service ProvidersRegistered NurseCollege Health