Provider Demographics
NPI:1023802188
Name:MONTGOMERY, AMY ROXANNE (RN)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ROXANNE
Last Name:MONTGOMERY
Suffix:
Gender:X
Credentials:RN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:ROXANNE
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:337 W MONTICELLO PIKE
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37756-4103
Mailing Address - Country:US
Mailing Address - Phone:423-539-6013
Mailing Address - Fax:
Practice Address - Street 1:337 W MONTICELLO PIKE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37756-4103
Practice Address - Country:US
Practice Address - Phone:423-539-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-05
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN223449163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management