Provider Demographics
NPI:1174245963
Name:CAMPBELL, TRANICEIA (CNA, LMT, RMP)
Entity type:Individual
Prefix:
First Name:TRANICEIA
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CNA, LMT, RMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3230 13TH ST NW UNIT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2694
Mailing Address - Country:US
Mailing Address - Phone:202-400-5796
Mailing Address - Fax:
Practice Address - Street 1:3701 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-4556
Practice Address - Country:US
Practice Address - Phone:202-237-7681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMT200001397225700000X
MDR03765225700000X
DCNA0000813390376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCMT200001397OtherDEPARTMENT OF HEALTH
MDR03765OtherMARYLAND STATE BOARD OF MASSAGE
DCNA0000813390OtherDEPARTMENT OF HEALTH