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General NPI Number Information
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NPI Number | 1083208003
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Entity Type | Individual
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Provider Name | KELLY KOMPINSKI PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 878 109TH AVE N
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City | NAPLES
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State | FL
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Zip | 34108-1814
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Country | US
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Telephone | 239-513-1002
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Fax | 239-513-1915
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Provider Business Mailing Address
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Address Line | 3835 41ST AVE NE
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City | NAPLES
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State | FL
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Zip | 34120-1884
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Country | US
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Telephone | 239-470-1650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9114058
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License Number State | FL
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