Provider Demographics
NPI:1548498108
Name:MONTANO, LYNNE D (APN)
Entity type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:D
Last Name:MONTANO
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TITUS CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-2218
Mailing Address - Country:US
Mailing Address - Phone:908-874-0019
Mailing Address - Fax:
Practice Address - Street 1:315 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-3109
Practice Address - Country:US
Practice Address - Phone:908-722-6900
Practice Address - Fax:908-722-6699
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00210000363LA2100X
MARN176174363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care