Provider Demographics
NPI:1831288497
Name:COMPTON, PATRICIA LUCY (RD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LUCY
Last Name:COMPTON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CHRISTOPHER LN
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-6205
Mailing Address - Country:US
Mailing Address - Phone:703-450-4465
Mailing Address - Fax:703-450-6156
Practice Address - Street 1:10 CHRISTOPHER LN
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6205
Practice Address - Country:US
Practice Address - Phone:703-450-4465
Practice Address - Fax:703-450-6156
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAR488001133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA24062OtherOPTIMUM CHOICE
VA24062OtherONE NET
VA24062OtherMDIPA
VA1028135OtherAETNA
VA24062OtherUNITED
VA24062OtherMAMSI
VAF202 0001OtherCARE FIRST
VA2676623-001OtherCIGNA
VA5640586OtherAETNA