Provider Demographics
NPI:1740240159
Name:KOEHN, DARCY (ARNP)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:KOEHN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:DARCY
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2309 C ST SW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52404-3707
Mailing Address - Country:US
Mailing Address - Phone:319-365-9165
Mailing Address - Fax:319-369-4677
Practice Address - Street 1:1030 5TH AVE SE
Practice Address - Street 2:SUITE 3000
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403
Practice Address - Country:US
Practice Address - Phone:319-286-4545
Practice Address - Fax:319-368-3358
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA041211363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA012189Medicaid
IA012189Medicaid