Healthcare Provider Details

I. General information

NPI: 1205472552
Provider Name (Legal Business Name): PLANNED PARENTHOOD OF THE ROCKY MOUNTAINS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/21/2019
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 SAINT MICHAELS DR # 4B
SANTA FE NM
87505-7606
US

IV. Provider business mailing address

7155 E 38TH AVE
DENVER CO
80207-1630
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-3684
  • Fax: 505-982-7204
Mailing address:
  • Phone: 505-944-2021
  • 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