Provider Demographics
NPI:1427700608
Name:LLOYD, MONTRAY (RN)
Entity type:Individual
Prefix:
First Name:MONTRAY
Middle Name:
Last Name:LLOYD
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6445 AMERICA BLVD APT 210
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2390
Mailing Address - Country:US
Mailing Address - Phone:252-767-8395
Mailing Address - Fax:
Practice Address - Street 1:6445 AMERICA BLVD APT 210
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20782-2390
Practice Address - Country:US
Practice Address - Phone:252-767-8395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC500001654163W00000X, 163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163W00000XNursing Service ProvidersRegistered Nurse