Healthcare Provider Details

I. General information

NPI: 1770523722
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF THE HEARTLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 08/15/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10534 NEW YORK AVENUE
URBANDALE IA
50322-3775
US

IV. Provider business mailing address

671 VANDALIA ST ATTN: PPH
ST. PAUL MN
55114-1312
US

V. Phone/Fax

Practice location:
  • Phone: 515-276-0579
  • Fax: 515-280-9525
Mailing address:
  • Phone: 866-290-4325
  • Fax: 515-280-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF077772
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01898
License Number StateIA

VIII. Authorized Official

Name: RANDY DRAGER
Title or Position: CFO
Credential:
Phone: 651-698-2406