Provider Demographics
NPI:1306681267
Name:MCCLUNG-COMPTON, ROWAN MARIE
Entity type:Individual
Prefix:
First Name:ROWAN
Middle Name:MARIE
Last Name:MCCLUNG-COMPTON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:MARCUS
Other - Middle Name:
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1246 N ELLSWORTH AVE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-1540
Mailing Address - Country:US
Mailing Address - Phone:734-707-3472
Mailing Address - Fax:
Practice Address - Street 1:1246 N ELLSWORTH AVE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-1540
Practice Address - Country:US
Practice Address - Phone:734-707-3472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker