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Individual

MRS. JENNIFER C COMPTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A.

Contact information

Practice address
4848 FORT HENRY DR, KINGSPORT, TN 37663-3347
(423) 857-2066
(423) 857-2066
Mailing address
PO BOX 9, KINGSPORT, TN 37662-0009
(423) 857-2066
(423) 390-3339

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000000275
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080194591
RAILROAD MEDICARE
TN
05
103I977037
TN
01
246269
ANTHEM BCBS VA
VA
01
4059748
BCBS TN
TN
01
5645956
VA MEDICAID
VA
01
830342546
JOHN DEERE
TN
Enumeration date
06/16/2005
Last updated
11/29/2017
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