Provider Demographics
NPI:1104253749
Name:COMPTON, NANCY L
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:L
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:PO BOX 83
Mailing Address - Street 2:
Mailing Address - City:EAST GREENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18041-0083
Mailing Address - Country:US
Mailing Address - Phone:267-733-7019
Mailing Address - Fax:
Practice Address - Street 1:2314 E BUCK RD
Practice Address - Street 2:
Practice Address - City:PENNSBURG
Practice Address - State:PA
Practice Address - Zip Code:18073-2327
Practice Address - Country:US
Practice Address - Phone:215-300-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-27
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW005879E104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker