Basic Information
| Provider Information | |||||||||
| NPI: | 1396974325 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POMPEY | ||||||||
| FirstName: | AUGUSTINA | ||||||||
| MiddleName: | LANA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | WOMACK ARMY MEDICAL CTR | ||||||||
| Address2: | 2817 REILLY ROAD MCXC-COD CREDENTIALS | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109079645 | ||||||||
| FaxNumber: | 9109076069 | ||||||||
| Practice Location | |||||||||
| Address1: | WOMACK ARMY MEDICAL CTR | ||||||||
| Address2: | 2817 REILLY ROAD MCXC-COD CREDENTIALS | ||||||||
| City: | FORT BRAGG | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283100001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9109079645 | ||||||||
| FaxNumber: | 9109076069 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/13/2009 | ||||||||
| LastUpdateDate: | 10/22/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 164W00000X | 056306 | NC | N | Nursing Service Providers | Licensed Practical Nurse | 1041C0700X | C007415 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
ID Information
| ID | Type | State | Issuer | Description | Q1-0001030 | 01 | DE | STATE OF DELAWARE BOARD OF CLINICAL SOCIAL WORK EXAMINERS | OTHER | 056306 | 01 | NC | NORTH CAROLINA BOARD OF NURSING | OTHER | C007415 | 01 | NC | NORTH CAROLINA SOCIAL WORK BOARD | OTHER |