Provider Demographics
NPI:1770606477
Name:PLANNED PARENTHOOD OF COLLIER COUNTY
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF COLLIER COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AFFILIATE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:STALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-262-8923
Mailing Address - Street 1:1425 CREECH RD
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34103-4207
Mailing Address - Country:US
Mailing Address - Phone:239-262-8923
Mailing Address - Fax:239-262-7658
Practice Address - Street 1:1425 CREECH RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34103-4207
Practice Address - Country:US
Practice Address - Phone:239-262-8923
Practice Address - Fax:239-262-7658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty