Provider Demographics
NPI:1639713902
Name:ZOMPANTI, KAITLIN ASHLEY (NP)
Entity type:Individual
Prefix:
First Name:KAITLIN
Middle Name:ASHLEY
Last Name:ZOMPANTI
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 1:1 BARBARY LN
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1519
Mailing Address - Country:US
Mailing Address - Phone:732-947-2355
Mailing Address - Fax:
Practice Address - Street 1:2137 HWY 35 # 160
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1083
Practice Address - Country:US
Practice Address - Phone:848-278-7366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-30
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2289441163W00000X, 363LF0000X
NJ26NJ14946700363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner