Montgomery, Juandria Nicole

Montgomery, Juandria Nicole is an individual health care provider with primary practice located at 6025 Stage Rd Ste 42-346 , Bartlett TN 38134-8374. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Montgomery, Juandria Nicole can be contacted via phone (901) 443-7353.

Contact Information

Primary practice address
6025 Stage Rd Ste 42-346 Bartlett TN 38134-8374
Phone: (901) 443-7353
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 17626 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 274081 Georgia

Profile Details

NPI number 1730208083
LBN Legal business name Montgomery, Juandria Nicole
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2007
Last updated Dec 28th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730208083 NPPES
Tennessee Other 6011441 BLUE CROSS AND BLUE SHIELD
Tennessee MEDICAID Q001302 BLUE CROSS AND BLUE SHIELD

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