Healthcare Provider Details

I. General information

NPI: 1770427361
Provider Name (Legal Business Name): EMILY CLARE MONTGOMERY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 S MOUNT AUBURN RD STE 200
CAPE GIRARDEAU MO
63703-4941
US

IV. Provider business mailing address

582 MONTERRA
CAPE GIRARDEAU MO
63701-8390
US

V. Phone/Fax

Practice location:
  • Phone: 573-339-1101
  • Fax:
Mailing address:
  • Phone: 573-270-1369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: