Provider Demographics
NPI:1114035094
Name:COMPEAU, DARLENE (NP)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:
Last Name:COMPEAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 GOVERNMENT CENTER DR
Mailing Address - Street 2:SUITE 230
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-1696
Mailing Address - Country:US
Mailing Address - Phone:910-798-7171
Mailing Address - Fax:910-798-7106
Practice Address - Street 1:230 GOVERNMENT CENTER DR
Practice Address - Street 2:SUITE 230
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-1696
Practice Address - Country:US
Practice Address - Phone:910-798-7171
Practice Address - Fax:910-798-7106
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0050-01280363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC187094OtherMEDCOST
NC25926939AMedicare UPIN
NC187094OtherMEDCOST
NC2313218Medicare ID - Type Unspecified