Healthcare Provider Details

I. General information

NPI: 1770129025
Provider Name (Legal Business Name): ROCKY MOUNTAIN PLANNED PARENTHOOD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 E 20TH ST
FARMINGTON NM
87401-9022
US

IV. Provider business mailing address

7155 E 38TH AVE
DENVER CO
80207-1630
US

V. Phone/Fax

Practice location:
  • Phone: 505-327-0451
  • Fax: 505-325-0933
Mailing address:
  • Phone: 505-944-2021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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