Provider Demographics
NPI:1760555973
Name:PLANNED PARENTHOOD MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA
Entity Type:Organization
Organization Name:PLANNED PARENTHOOD MINNESOTA, NORTH DAKOTA, SOUTH DAKOTA
Other - Org Name:PLAN EXPRESS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-696-5509
Mailing Address - Street 1:1965 FORD PKWY
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-1923
Mailing Address - Country:US
Mailing Address - Phone:651-696-5509
Mailing Address - Fax:651-698-2406
Practice Address - Street 1:15322 GALAXIE AVENUE SOUTH
Practice Address - Street 2:SUITE 110
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124
Practice Address - Country:US
Practice Address - Phone:952-351-9998
Practice Address - Fax:952-351-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty