Provider Demographics
NPI:1023379591
Name:CAMPBELL, KIARA C
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:C
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4214 4TH ST SE
Mailing Address - Street 2:APT # 102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-3324
Mailing Address - Country:US
Mailing Address - Phone:202-409-6135
Mailing Address - Fax:
Practice Address - Street 1:4214 4TH ST SE
Practice Address - Street 2:APT # 102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-3324
Practice Address - Country:US
Practice Address - Phone:202-409-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-31
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide