Provider Demographics
NPI:1336973478
Name:KWILINSKI, ALEXX LYNN (DNP)
Entity type:Individual
Prefix:
First Name:ALEXX
Middle Name:LYNN
Last Name:KWILINSKI
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 WILLIAMS BLVD SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-1480
Mailing Address - Country:US
Mailing Address - Phone:319-800-5564
Mailing Address - Fax:319-205-0058
Practice Address - Street 1:3255 WILLIAMS BLVD SW
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52404-1480
Practice Address - Country:US
Practice Address - Phone:319-800-5564
Practice Address - Fax:319-205-0058
Is Sole Proprietor?:No
Enumeration Date:2024-08-30
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAH181102363LA2200X
IAG181101363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health