Provider Demographics
NPI:1083844567
Name:WEIKERT, ANDREA K
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:WEIKERT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 FOREST DR NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-2016
Mailing Address - Country:US
Mailing Address - Phone:612-388-5237
Mailing Address - Fax:
Practice Address - Street 1:2937 LYNDALE AVE S
Practice Address - Street 2:SUITE 201
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2171
Practice Address - Country:US
Practice Address - Phone:612-879-8000
Practice Address - Fax:612-879-8778
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-20
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN654134053215174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist