Provider Demographics
NPI:1881091072
Name:COMPTON, ELIZABETH CLAIRE (AGNP)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:COMPTON
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5451 MARKRIDGE RD APT 8309
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6041
Mailing Address - Country:US
Mailing Address - Phone:252-341-6343
Mailing Address - Fax:888-787-2249
Practice Address - Street 1:3024 NEW BERN AVE STE G03
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1247
Practice Address - Country:US
Practice Address - Phone:919-350-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-03
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007269363LA2200X, 363LA2200X
NC232372363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1881091072Medicaid
NCNCM178AMedicare PIN