Healthcare Provider Details
I. General information
NPI: 1881230209
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: 06/15/2023
Certification Date: 06/15/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
921 E 14TH AVE
DENVER CO
80218-1903
US
IV. Provider business mailing address
719 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1434
US
V. Phone/Fax
- Phone: 303-832-5069
- Fax: 303-832-1410
- Phone: 505-485-0464
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VX0000X |
| Taxonomy | Obstetrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0005X |
| Taxonomy | Ambulatory Family Planning Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MARISSA
HERRERA
Title or Position: CREDENTIALING
Credential:
Phone: 505-944-2021