Provider Demographics
NPI:1881145332
Name:BAANE, CELINE SANDRINE
Entity type:Individual
Prefix:
First Name:CELINE
Middle Name:SANDRINE
Last Name:BAANE
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 1:2714 UPSHUR ST
Mailing Address - Street 2:APT 4
Mailing Address - City:MOUNT RAINIER
Mailing Address - State:MD
Mailing Address - Zip Code:20712-1514
Mailing Address - Country:US
Mailing Address - Phone:202-286-8014
Mailing Address - Fax:
Practice Address - Street 1:2714 UPSHUR ST
Practice Address - Street 2:APT 4
Practice Address - City:MOUNT RAINIER
Practice Address - State:MD
Practice Address - Zip Code:20712-1514
Practice Address - Country:US
Practice Address - Phone:202-286-8014
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12465374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide