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General NPI Number Information
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NPI Number | 1124495080
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Entity Type | Individual
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Provider Name | DEENA MONTGOMERY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 820 N MOUNT JULIET RD STE 105
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City | MT JULIET
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State | TN
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Zip | 37122-4186
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Country | US
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Telephone | 615-601-8949
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Fax | 615-601-8948
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Provider Business Mailing Address
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Address Line | 933 CANYON CREEK DR
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City | LEBANON
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State | TN
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Zip | 37087-2478
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Country | US
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Telephone | 615-692-2998
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Fax |
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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 | 19960
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License Number State | TN
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