Provider Demographics
NPI:1538781216
Name:MONTGOMERY, ASHLEE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:ELIZABETH
Other - Last Name:WHALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:407 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6109
Mailing Address - Country:US
Mailing Address - Phone:423-943-3886
Mailing Address - Fax:
Practice Address - Street 1:407 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6109
Practice Address - Country:US
Practice Address - Phone:423-943-3886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-15
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27442363LF0000X
TN182528163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily