Healthcare Provider Details

I. General information

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

II. Dates (important events)

Enumeration Date: 10/10/2017
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 N SIOUX POINT RD SUITE 100
DAKOTA DUNES SD
57049-5067
US

IV. Provider business mailing address

600 1ST ST NW SUITE 101
MASON CITY IA
50401-2932
US

V. Phone/Fax

Practice location:
  • Phone: 712-222-7960
  • Fax: 472-222-7961
Mailing address:
  • Phone: 712-203-1640
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: