NPI 1164623716 · live from the CMS NPI Registry
Wiltse Crompton, cpnp
Nurse Practitioner, Pediatrics in Minneapolis, MN. National Provider Identifier 1164623716, active.
NPI record
| NPI | 1164623716 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 3433 Broadway St Ne, Minneapolis, MN 55413 |
| Practice phone | 612-617-4600 |
| Mailing address | 1504 Washburn Ave N, Minneapolis, MN 55411 |
| Enumerated | May 30, 2007 |
| Last updated | September 11, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse, Pediatrics | 163WP0200X | R 143878-1 (MN) |
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 20000337 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.