Tangala Sue Montgomery, LPN
Licensed Practical Nurse in Freeport, OH. Individual provider (NPI-1).
NPI number1063041663
StatusActive
Last updated in NPPESApr 6, 2020
Details
- NPI
- 1063041663
- Entity type
- Individual (NPI-1)
- Name
- Tangala Sue Montgomery
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 6, 2020
- Certification date
- Apr 6, 2020
- Last updated
- Apr 6, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 083268 | OH | Yes |
Other names
- Tangala Sue Quillin (Former Name)
Practice location
19253 Sligo RdFreeport, OH 43973-9660
Phone 740-260-0821
Mailing address
19253 Sligo RdFreeport, OH 43973-9660
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