Provider Demographics
NPI:1548282833
Name:PLANNED PARENTHOOD OF THE HEARTLAND, INC
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF THE HEARTLAND, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-698-2406
Mailing Address - Street 1:671 VANDALIA ST
Mailing Address - Street 2:ATTN: PPH
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1312
Mailing Address - Country:US
Mailing Address - Phone:515-280-7004
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:5631 SOUTH 48TH ST.
Practice Address - Street 2:STE. 100
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-4107
Practice Address - Country:US
Practice Address - Phone:402-441-3300
Practice Address - Fax:402-441-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE110111363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025088800Medicaid
NE277933Medicare ID - Type Unspecified
NE10025088800Medicaid