Provider Demographics
NPI:1366411035
Name:WOMEN'S HEALTH PROJECT, INC.
Entity type:Organization
Organization Name:WOMEN'S HEALTH PROJECT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-337-2112
Mailing Address - Street 1:227 N DUBUQUE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-1714
Mailing Address - Country:US
Mailing Address - Phone:319-337-2111
Mailing Address - Fax:319-337-2754
Practice Address - Street 1:227 N DUBUQUE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-1714
Practice Address - Country:US
Practice Address - Phone:319-337-2111
Practice Address - Fax:319-337-2754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA16606174400000X
IAF-077233363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA2209304Medicaid
IAA02310Medicare UPIN
IA15453Medicare ID - Type UnspecifiedROBERT M. KRETZSCHMAR