Healthcare Provider Details

I. General information

NPI: 1023379591
Provider Name (Legal Business Name): KIARA C CAMPBELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4214 4TH ST SE APT # 102
WASHINGTON DC
20032-3324
US

IV. Provider business mailing address

4214 4TH ST SE APT # 102
WASHINGTON DC
20032-3324
US

V. Phone/Fax

Practice location:
  • Phone: 202-409-6135
  • Fax:
Mailing address:
  • Phone: 202-409-6135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: