Montgomery, Sydney Nicole

Montgomery, Sydney Nicole is an sole proprietor health care provider with primary practice located at 500 Medical Center Blvd Ste 250 , Lawrenceville GA 30046-3402. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Obstetric, Inpatient, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Montgomery, Sydney Nicole can be contacted via phone (770) 979-4700.

Contact Information

Primary practice address
500 Medical Center Blvd Ste 250 Lawrenceville GA 30046-3402
Phone: (770) 979-4700
Fax: (770) 979-1060
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Obstetric, Inpatient 163WX0003X RN259595 Georgia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X RN259595 Georgia

Profile Details

NPI number 1447896956
LBN Legal business name Montgomery, Sydney Nicole
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 19th, 2019
Last updated Oct 6th, 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 1447896956 NPPES
Other 15385033 CAQH
MEDICAID 003256365 CAQH

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