MEDICARE: PLANNED PARENTHOOD MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1578543666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA

Provider Business Mailing Address
First Line	:	1965 FORD PKWY
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1923
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2320 HIGHWAY 12 E
Second Line	:	SUITE 6
City	:	WILLMAR
State	:	MN
Zip	:	56201-5811
Country	:	US
Telephone Number	:	320-235-9150
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL CREDENTIALING COORDINATOR
Name	:	PAMELA HOVE
Credential	:
Telephone Number	:	651-696-5509

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	08/22/2020

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Directions to “PLANNED PARENTHOOD MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA ” Practice Location

Language	Start Address	Practice Location

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