Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 102652 | AK |
NPI | 1013168855 |
---|---|
Provider Name | Katie M Montano |
First Address | Palmer, AK 99645 |
Second Address | Palmer, AK 99645-8984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 16/11/2017 |