Healthcare Provider Details

I. General information

NPI: 1699531673
Provider Name (Legal Business Name): CATHY MONTGOMERY DNP, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 STATE RD
CHERAW SC
29520-2130
US

IV. Provider business mailing address

PO BOX 1090
HARTSVILLE SC
29551-1090
US

V. Phone/Fax

Practice location:
  • Phone: 843-537-0961
  • Fax: 843-537-0908
Mailing address:
  • Phone: 843-857-0111
  • Fax: 843-309-8126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number29662
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: