Provider Demographics
NPI:1225894751
Name:COMPTON, SHANNON L (FNP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:L
Last Name:COMPTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:598 W 900 S
Mailing Address - Street 2:
Mailing Address - City:WOODS CROSS
Mailing Address - State:UT
Mailing Address - Zip Code:84010-8235
Mailing Address - Country:US
Mailing Address - Phone:801-475-5111
Mailing Address - Fax:
Practice Address - Street 1:598 W 900 S
Practice Address - Street 2:
Practice Address - City:WOODS CROSS
Practice Address - State:UT
Practice Address - Zip Code:84010-8235
Practice Address - Country:US
Practice Address - Phone:801-475-5111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7865907-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily