Healthcare Provider Details

I. General information

NPI: 1497712517
Provider Name (Legal Business Name): ANDREA J. COMPTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 10/29/2024
Certification Date: 10/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11787 LANTERN RD STE 200
FISHERS IN
46038-2801
US

IV. Provider business mailing address

11787 LANTERN RD STE 200
FISHERS IN
46038-2801
US

V. Phone/Fax

Practice location:
  • Phone: 317-957-9140
  • Fax:
Mailing address:
  • Phone: 317-957-9140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71001431A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: