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General NPI Number Information
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NPI Number | 1003323775
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Entity Type | Individual
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Provider Name | STACY LAMONTAGNA NP
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Gender | Female
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 803 W ARLINGTON ST
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City | BANGOR
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State | MI
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Zip | 49013-1108
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Country | US
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Telephone | 269-427-6810
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Fax | 269-427-6811
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Provider Business Mailing Address
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Address Line | PO BOX 249 801 HAZEN STREET, SUITE C
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City | PAW PAW
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State | MI
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Zip | 49079-0249
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Country | US
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Telephone | 269-657-5574
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Fax | 269-657-3474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704336065
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License Number State | MI
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