Montgomery, Shanon David

Montgomery, Shanon David is an individual health care provider with primary practice located at 440 Woodward Ave , Iron Mountain MI 49801-4631. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Montgomery, Shanon David can be contacted via phone (906) 776-9040.

Contact Information

Primary practice address
440 Woodward Ave Iron Mountain MI 49801-4631
Phone: (906) 776-9040
Fax: (906) 774-7279
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 4704217286 Michigan

Profile Details

NPI number 1710347901
LBN Legal business name Montgomery, Shanon David
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 1st, 2016
Last updated Feb 14th, 2020 - about 5 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 1710347901 NPPES
Other AG0216095 AMERICAN ACADEMY OF NURSE PRACTITIONERS

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