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General NPI Number Information
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NPI Number | 1942935218
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Entity Type | Individual
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Provider Name | MARLENA ANN MONTGOMERY FNP-C
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Gender | Female
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Dates
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Enumeration Date | 07/20/2022
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2101 W SPRING CREEK PKWY
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City | PLANO
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State | TX
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Zip | 75023-4103
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Country | US
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Telephone | 866-389-2727
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Fax |
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Provider Business Mailing Address
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Address Line | 143 S DENTON TAP RD STE 180
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City | COPPELL
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State | TX
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Zip | 75019-3375
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Country | US
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Telephone | 940-206-9535
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Fax | 512-782-9316
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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 | AP1086302
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License Number State | TX
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