Provider Demographics
NPI:1063184182
Name:HOUSE CALLS
Entity type:Organization
Organization Name:HOUSE CALLS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAUREEN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOEHLER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:252-945-7576
Mailing Address - Street 1:812 HUBS REC RD
Mailing Address - Street 2:
Mailing Address - City:BELHAVEN
Mailing Address - State:NC
Mailing Address - Zip Code:27810-9336
Mailing Address - Country:US
Mailing Address - Phone:252-945-7576
Mailing Address - Fax:252-359-5328
Practice Address - Street 1:812 HUBS REC RD
Practice Address - Street 2:
Practice Address - City:BELHAVEN
Practice Address - State:NC
Practice Address - Zip Code:27810-9336
Practice Address - Country:US
Practice Address - Phone:252-945-7576
Practice Address - Fax:252-359-5328
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOUSE CALLS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-28
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1063184182Medicaid
NC1730460064OtherINDIVIDUAL NPI
NC1730460064Medicaid