Doctor Name: | KERI LOUISE WEICK |
NPI Number: | 1518288299 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | |
Business Practice Address: | 800 3rd Ave Sw Rugby, ND - 583681645 |
Business Phone Number: | 7017765235 |
Business Fax Number: | |
Mailing Address: | 3381 26th Ave Ne, MARTIN |
State: | ND |
Postal Code: | 587589403 |
Phone Number: | 7016932234 |
Fax Number: | |
NPI Enumeration Date: | 06/17/2010 |
NPI Last Update Date: | 06/17/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |