Individual provider · Type 1 NPI
Ida Sue Montgomery, CRNP
Primary Care Nurse Practitioner · Fort Rucker, AL
NPI number
1104809359
Active
Practice location
301 Andrews Avenue, Lyster Army Outpatient Clinic
Fort Rucker, AL 36362
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | APRN-384 (HI) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1104809359
Ida Sue Montgomery, CRNP's National Provider Identifier is 1104809359, issued on Nov 22, 2005. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fort Rucker, AL. The record was last updated on Jul 13, 2026.