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General NPI Number Information
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NPI Number | 1356861348
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Entity Type | Individual
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Provider Name | ANCILLA ANNA ROMPALA MD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2017
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Last Update Date | 02/10/2024
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Provider Practice Location Address
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Address Line | 3186 S MARYLAND PKWY
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City | LAS VEGAS
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State | NV
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Zip | 89109-2317
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Country | US
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Telephone | 702-961-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 S INDIANA AVE APT 2601
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City | CHICAGO
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State | IL
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Zip | 60605-2787
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Country | US
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Telephone | 438-888-7245
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number | 24907
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License Number State | NV
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