Provider Demographics
NPI:1881882017
Name:COMPTON, JINNA
Entity type:Individual
Prefix:MRS
First Name:JINNA
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 MORRISON CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-3744
Mailing Address - Country:US
Mailing Address - Phone:501-658-5081
Mailing Address - Fax:
Practice Address - Street 1:43 MORRISON CT
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-3744
Practice Address - Country:US
Practice Address - Phone:501-658-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-12
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#2556235Z00000X
ARSP#P8042235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164611721Medicaid