Provider Demographics
NPI:1962558957
Name:OKINE, ALBERT (PA-C, MSPAS)
Entity type:Individual
Prefix:MR
First Name:ALBERT
Middle Name:
Last Name:OKINE
Suffix:
Gender:M
Credentials:PA-C, MSPAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 SOUTHERN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-4736
Mailing Address - Country:US
Mailing Address - Phone:712-274-6729
Mailing Address - Fax:712-274-6744
Practice Address - Street 1:3549 SOUTHERN HILLS DR
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4736
Practice Address - Country:US
Practice Address - Phone:712-274-6729
Practice Address - Fax:712-274-6744
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0017762084P0800X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry