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Olivia R Montgomery

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2001 Laurel Ave # N304, Knoxville, TN 37916-1810

PECOS Enrollment

This provider is enrolled in PECOS as OLIVIA MONTGOMERY.

Based on the most recent information from CMS, provider Olivia R Montgomery is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 11:00 AM.

Profile Details

Provider ID
1326773854
Provider Type
Individual
Full Name
Montgomery, Olivia R
Title
Dr.
Credential
DNP, FNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
7/19/2022
Last Updated
8/22/2024

Contact Information

Practice Location

2001 Laurel Ave # N304, Knoxville, TN 37916-1810

(865) 595-4100

Unlisted Fax

Mailing Location

2001 Laurel Ave # N304, Knoxville, TN 37916-1810

(865) 595-4100

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 202209875NP-PP Oregon

Olivia R Montgomery

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Campbell, Amy Louise

Cantrill, Deena

Loop, Amy

Hurst, Natalie Ann Civinelli

Thompson-Long, Keisha

Hull, Darrel T

Payne, Rachel

Art, Olivia Caroline

Archer, Tanya

Self, Ashley Nichole