Provider Demographics
NPI:1790654176
Name:CRISS, MONTANA DEE
Entity type:Individual
Prefix:
First Name:MONTANA
Middle Name:DEE
Last Name:CRISS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2929 BULGER RD
Mailing Address - Street 2:
Mailing Address - City:ALKOL
Mailing Address - State:WV
Mailing Address - Zip Code:25501-9683
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2929 BULGER RD
Practice Address - Street 2:
Practice Address - City:ALKOL
Practice Address - State:WV
Practice Address - Zip Code:25501-9683
Practice Address - Country:US
Practice Address - Phone:304-400-5167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-03
Last Update Date:2025-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant