Montgomery, Susan Leigh
Montgomery, Susan Leigh is an sole proprietor health care provider with primary practice located at 122 Weisenberger Road , Madison MS 39110-8561. 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, Susan Leigh can be contacted via phone (601) 790-9080.Contact Information
Primary practice address
122 Weisenberger Road
Madison MS 39110-8561
Phone: (601) 790-9080
Fax: (601) 790-9098
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R524174 | Mississippi |
Profile Details
| NPI number | 1447561345 |
|---|---|
| LBN Legal business name | Montgomery, Susan Leigh |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 24th, 2010 |
| Last updated | Feb 3rd, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1447561345 | NPPES |
| Mississippi | MEDICAID | 00116067 |
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