Healthcare Provider Details

I. General information

NPI: 1336052356
Provider Name (Legal Business Name): LAVELL DOUGLAS ROLLINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 HALF ST SE APT G58
WASHINGTON DC
20003-4178
US

IV. Provider business mailing address

5530 LIVINGSTON TER APT 202
OXON HILL MD
20745-2426
US

V. Phone/Fax

Practice location:
  • Phone: 202-391-3158
  • Fax:
Mailing address:
  • Phone: 202-391-3158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: