Provider Demographics
NPI:1114716438
Name:MONTAG, NANCY JANE
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:JANE
Last Name:MONTAG
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 N 104TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-3796
Mailing Address - Country:US
Mailing Address - Phone:402-939-9840
Mailing Address - Fax:
Practice Address - Street 1:3515 N 104TH AVE APT 8
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68134-3796
Practice Address - Country:US
Practice Address - Phone:402-939-9840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant