Provider Demographics
NPI:1689391427
Name:COMPTON, TANNA (NP)
Entity Type:Individual
Prefix:
First Name:TANNA
Middle Name:
Last Name:COMPTON
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 1:783 S 20TH ST
Mailing Address - Street 2:
Mailing Address - City:MC CUNE
Mailing Address - State:KS
Mailing Address - Zip Code:66753-6184
Mailing Address - Country:US
Mailing Address - Phone:620-404-8088
Mailing Address - Fax:
Practice Address - Street 1:783 S 20TH ST
Practice Address - Street 2:
Practice Address - City:MC CUNE
Practice Address - State:KS
Practice Address - Zip Code:66753-6184
Practice Address - Country:US
Practice Address - Phone:620-404-8088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2022038983363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily