Provider Demographics
NPI:1447720941
Name:RLJ VISITING HOUSECALLS LLC
Entity type:Organization
Organization Name:RLJ VISITING HOUSECALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:214-676-3861
Mailing Address - Street 1:2202 S COCKRELL HILL RD UNIT 210676
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75211-8535
Mailing Address - Country:US
Mailing Address - Phone:214-676-3861
Mailing Address - Fax:214-337-1097
Practice Address - Street 1:3603 CREEK VIEW DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75233-1709
Practice Address - Country:US
Practice Address - Phone:214-676-3861
Practice Address - Fax:214-337-1097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP112117OtherTEXAS BOARD OF NURSING
TX243922OtherBOARD OF NURSE EXAMINERS