| NPI | 1720429095 |
|---|---|
| Former Name | KIMBERLY ANN MONTGOMERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95011334) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: OH COA.14778-NP) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2019-03-15 |