Individual provider · Type 1 NPI
Ebony Monique Montgomery, APRN
Gerontology Nurse Practitioner · Jacksonville, AR
NPI number
1629531595
Active
Practice location
1410 Braden Street
Jacksonville, AR 72076
Fax (844) 447-2520
Mailing address
500 SW 7th St STEA205
Renton, WA 98057
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 125407 (AR) |
Gerontology Nurse Practitioner: Definition to come...
About NPI 1629531595
Ebony Monique Montgomery, APRN's National Provider Identifier is 1629531595, issued on Apr 8, 2019. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Jacksonville, AR. The record was last updated on Feb 26, 2025.