Healthcare Provider Details

I. General information

NPI: 1417593849
Provider Name (Legal Business Name): ROCKY MOUNTAIN PLANNED PARENTHOOD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2019
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 CENTENNIAL BLVD
COLORADO SPRINGS CO
80907-4087
US

IV. Provider business mailing address

719 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1434
US

V. Phone/Fax

Practice location:
  • Phone: 719-475-7162
  • Fax: 719-475-2201
Mailing address:
  • Phone: 505-485-0464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: MARISSA HERRERA
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 505-944-2021