Provider Demographics
NPI:1578162772
Name:COMPTON, TANA
Entity Type:Individual
Prefix:
First Name:TANA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 231
Mailing Address - Street 2:
Mailing Address - City:ACCOVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25606
Mailing Address - Country:US
Mailing Address - Phone:304-688-1237
Mailing Address - Fax:
Practice Address - Street 1:3324 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302
Practice Address - Country:US
Practice Address - Phone:304-766-2665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant