Provider Demographics
NPI:1821052853
Name:COMPTON, GAIL (NP)
Entity Type:Individual
Prefix:
First Name:GAIL
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 1:940 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3497
Mailing Address - Country:US
Mailing Address - Phone:573-302-7891
Mailing Address - Fax:573-302-7974
Practice Address - Street 1:246 RE HIGHWAY 54
Practice Address - Street 2:
Practice Address - City:CAMDENTON
Practice Address - State:MO
Practice Address - Zip Code:65020
Practice Address - Country:US
Practice Address - Phone:573-317-1150
Practice Address - Fax:573-317-1151
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO149317163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice