Healthcare Provider Details

I. General information

NPI: 1316503808
Provider Name (Legal Business Name): JULIE MONTEIRO-PAI CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2019
Last Update Date: 03/21/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4181 HOSPITAL DR NE STE 202
COVINGTON GA
30014-2541
US

IV. Provider business mailing address

126 COUNT FLEET CT
MADISON AL
35756-4284
US

V. Phone/Fax

Practice location:
  • Phone: 770-385-4291
  • Fax:
Mailing address:
  • Phone: 256-476-6803
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF04190105
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberGAA-NP001221
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: