Provider Demographics
NPI:1225317183
Name:PLANNED PARENTHOOD OF THE HEARTLAND
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD OF THE HEARTLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:DICKEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:515-235-0450
Mailing Address - Street 1:1171 7TH ST
Mailing Address - Street 2:PLANNED PARENTHOOD OF THE HEARTLAND
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-4557
Mailing Address - Country:US
Mailing Address - Phone:877-811-7526
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:2201 AVE H
Practice Address - Street 2:PLANNED PARENTHOOD OF THE HEARTLAND FORT MADISON CLINIC
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-4048
Practice Address - Country:US
Practice Address - Phone:319-372-1130
Practice Address - Fax:319-372-6040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-10
Last Update Date:2011-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA33019363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAGROUP0057570Medicaid
IAGROUP0057570Medicaid