MEDICARE: MRS. JACLYN NICOLE MONTGOMERY APRN, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	33639	TN

General Provider Information

NPI Number	:	1043917297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JACLYN NICOLE MONTGOMERY APRN, FNP-BC

Provider Business Mailing Address
First Line	:	110 DUNHILL PL NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3866
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 DUNHILL PL NW
Second Line	:
City	:	CLEVELAND
State	:	TN
Zip	:	37311-3866
Country	:	US
Telephone Number	:	423-476-2212
Fax Number	:	423-476-7022

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/08/2023
Last Update Date	:	05/12/2026

Similar Medicare Providers

1528083151 — DR. GEORGE A. SAMUEL D.O.
Practice Location Address:

110 DUNHILL PL NW , SUITE B
CLEVELAND, TN
37311-3866

Practice Phone: 423-339-2000
Practice Fax: 423-339-2043

1508301086 — J & L ENTERPRISES, LLC
Practice Location Address:

110 DUNHILL PL NW , SUITE B
CLEVELAND, TN
37311-3866

Practice Phone: 423-790-7792
Practice Fax: 706-270-0487

1831730332 — MRS. CINDY LYNN COCHRAN CCSH,RPSGT,RST
Practice Location Address:

110 DUNHILL PL NW
CLEVELAND, TN
37311-3866

Practice Phone: 423-476-2212
Practice Fax: 423-476-7022

1073565883 — SPORTS REHABILITATION CONSULTANTS, INC.
Practice Location Address:

3866 CARNEGIE AVE
CLEVELAND, OH
44115-2718

Practice Phone: 216-621-0022
Practice Fax: 216-621-5479

1013961911 — MR. MICHAEL A DERUBERTIS P.T.
Practice Location Address:

3866 CARNEGIE AVE
CLEVELAND, OH
44115-2718

Practice Phone: 216-621-0022
Practice Fax: 216-621-5479

1265539308 — MS. SHELLEY SEARS BERVEN MSW
Practice Location Address:

790 CLEVELAND AVE S STE 207
SAINT PAUL, MN
55116-3866

Practice Phone: 651-224-3035
Practice Fax: 651-690-0968

Directions to “ MRS. JACLYN NICOLE MONTGOMERY APRN, FNP-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.