Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MACKENZIE J WEIS
Active Sole ProprietorMACKENZIE J WEIS is a Physician Assistant healthcare provider located in SOUTH HAVEN, Minnesota. NPI 1104636547 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · SOUTH HAVEN, MN
Registration Details
- NPI Number
- 1104636547
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 8, 2025 (1.5892550113305 yrs)
- Last Updated
- Jul 2, 2025
- License
-
15408 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
306 149TH STSOUTH HAVEN, MN, 553829140Browse MN providers · Browse ZIP 55382
- Phone
- 3202910229
- Primary Specialty
-
Physician Assistant
363A00000X
- Additional Specialty
- Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.