Healthcare Provider Details

I. General information

NPI: 1174514095
Provider Name (Legal Business Name): PLANNED PARENTHOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MAPLEWOOD AVE
WINSTON-SALEM NC
27103-4002
US

IV. Provider business mailing address

3000 MAPLEWOOD AVE
WINSTON-SALEM NC
27103-4002
US

V. Phone/Fax

Practice location:
  • Phone: 336-768-2980
  • Fax: 336-765-6599
Mailing address:
  • Phone: 336-768-2980
  • Fax: 336-765-6599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number900459
License Number StateNC

VIII. Authorized Official

Name: MRS. JENNIFER LUZIA-ULIN CERNY
Title or Position: NURSE PRACTITIONER
Credential: RN, MS, NP-C
Phone: 336-768-2980