Provider Demographics
NPI:1760775233
Name:IANNONE, ALEXANDRA BASTIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:BASTIAN
Last Name:IANNONE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALEXANDRA
Other - Middle Name:NICHOLE
Other - Last Name:BASTIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-8676
Mailing Address - Fax:319-356-8383
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242
Practice Address - Country:US
Practice Address - Phone:319-353-8676
Practice Address - Fax:319-356-8383
Is Sole Proprietor?:No
Enumeration Date:2011-05-17
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADO-04591208000000X, 2080P0214X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology