Provider Demographics
NPI:1720766801
Name:COMPTON, AMANDA KATHERINE (FNTP, RWP)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:KATHERINE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:FNTP, RWP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MATLAGE WAY # 302
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-9998
Mailing Address - Country:US
Mailing Address - Phone:281-881-9025
Mailing Address - Fax:
Practice Address - Street 1:4614 MAGNOLIA LN
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5448
Practice Address - Country:US
Practice Address - Phone:281-881-9025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3199133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist