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General NPI Number Information
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NPI Number | 1265246698
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Entity Type | Individual
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Provider Name | DANIELLE JEAN MONTOYA CSFA
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Gender | Female
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Dates
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Enumeration Date | 02/05/2025
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 2900 W OKLAHOMA AVE
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City | MILWAUKEE
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State | WI
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Zip | 53215-4330
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Country | US
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Telephone | 262-893-3683
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Fax |
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Provider Business Mailing Address
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Address Line | 1907 S 92ND ST
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City | WEST ALLIS
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State | WI
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Zip | 53227-1515
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Country | US
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Telephone | 262-893-3683
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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 | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | 205980
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License Number State | CO
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