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1386512937 NPI number — KELLI MONTZ DOUGHERTY RN

NPI Number: 1386512937
Health Care Provider/Practitioner: KELLI MONTZ DOUGHERTY RN

Information about “1386512937” NPI (KELLI MONTZ DOUGHERTY RN) exists in 1386512937 in HTML format HTML  |  1386512937 in plain Text format TXT  |  1386512937 in PDF (Portable Document Format) PDF  |  1386512937 in an XML format XML  formats.

NPI Number : 1386512937 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1386512937",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DOUGHERTY",
    "FirstName": "KELLI",
    "MiddleName": "MONTZ",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "RN",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2000 6TH AVE S FL 4",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BIRMINGHAM",
    "MailingAddressStateName": "AL",
    "MailingAddressPostalCode": "35233-2110",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2000 6TH AVE S FL 4",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BIRMINGHAM",
    "PracticeLocationAddressStateName": "AL",
    "PracticeLocationAddressPostalCode": "35233-2110",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "205-996-5864",
    "PracticeLocationAddressFaxNumber": "205-583-8043",
    "EnumerationDate": "10/27/2025",
    "LastUpdateDate": "10/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "163W00000X",
          "TaxonomyName": "Registered Nurse",
          "LicenseNumber": "1-176031",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "163WC0200X",
          "TaxonomyName": "Critical Care Medicine Registered Nurse",
          "LicenseNumber": "1-176031",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "163WP2201X",
          "TaxonomyName": "Ambulatory Care Registered Nurse",
          "LicenseNumber": "1-176031",
          "LicenseNumberStateCode": "AL",
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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