Healthcare Provider Details

I. General information

NPI: 1447164751
Provider Name (Legal Business Name): PATRICK MONTGOMERY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 ONEIDA VALLEY RD
BUTLER PA
16001-2239
US

IV. Provider business mailing address

5001 PENDLETON WAY APT 5412
CRANBERRY TWP PA
16066-6941
US

V. Phone/Fax

Practice location:
  • Phone: 833-995-0118
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberSP036096
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: