Provider Demographics
NPI:1003845645
Name:COMP, JUANITA J (APRN,BC)
Entity Type:Individual
Prefix:MS
First Name:JUANITA
Middle Name:J
Last Name:COMP
Suffix:
Gender:F
Credentials:APRN,BC
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Mailing Address - Street 1:2512 SHERRY DR
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-8395
Mailing Address - Country:US
Mailing Address - Phone:717-709-4789
Mailing Address - Fax:717-267-7790
Practice Address - Street 1:112 COLDBROOK AVE
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201
Practice Address - Country:US
Practice Address - Phone:717-267-7480
Practice Address - Fax:717-267-7790
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN136955L364SP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0807XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Child & Adolescent