MEDICARE: PLANNED PARENTHOOD OF THE HEARTLAND

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	363LW0102X	Women's Health Nurse Practitioner	F092601	IA
2	363LW0102X	Women's Health Nurse Practitioner	F074371	IA
3	207Q00000X	Family Medicine Physician	01898	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811937881
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLANNED PARENTHOOD OF THE HEARTLAND

Provider Business Mailing Address
First Line	:	671 VANDALIA ST
Second Line	:	ATTN: PPH
City	:	ST. PAUL
State	:	MN
Zip	:	55114-1312
Country	:	US
Telephone Number	:	866-290-4325
Fax Number	:	515-280-9525

Provider Business Practice Location Address
First Line	:	4409 STONE AVE
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	50315-5939
Country	:	US
Telephone Number	:	866-290-4325
Fax Number	:	515-280-9525

Authorized Official
Title or Position	:	CFO
Name	:	RANDY DRAGER
Credential	:
Telephone Number	:	651-698-2406

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	08/15/2024

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Directions to “PLANNED PARENTHOOD OF THE HEARTLAND ” Practice Location

Language	Start Address	Practice Location

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