Provider Demographics
NPI:1487008157
Name:HOUSECALL
Entity Type:Organization
Organization Name:HOUSECALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLUM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:501-580-6282
Mailing Address - Street 1:16 RIDING RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-2328
Mailing Address - Country:US
Mailing Address - Phone:501-580-6282
Mailing Address - Fax:
Practice Address - Street 1:16 RIDING RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-2328
Practice Address - Country:US
Practice Address - Phone:501-580-6282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA00347363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty