Healthcare Provider Details

I. General information

NPI: 1013427640
Provider Name (Legal Business Name): ALEXANDRIA LYNN KOHN CHICOINE FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 GORDON DR
SIOUX CITY IA
51101-1829
US

IV. Provider business mailing address

833 GORDON DR
SIOUX CITY IA
51101-1829
US

V. Phone/Fax

Practice location:
  • Phone: 712-203-1640
  • Fax: 712-587-7992
Mailing address:
  • Phone: 712-203-1640
  • Fax: 712-587-7992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA134175
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA134175
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCP001752
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: