Individual
KIRTLEY GRACE COMPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232
Mailing address
5803 NEAL AVE N, OAK PARK HEIGHTS, MN 55082-2177
(651) 439-8807
(651) 439-0232
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11885
MN
363AS0400X
Surgical Physician Assistant
3580
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467839209
—
MN
Enumeration date
04/30/2015
Last updated
03/11/2021
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