Provider Demographics
NPI:1275546723
Name:WEEKS, SANDRA LEE (ANP)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:WEEKS
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 62 BOX 5386
Mailing Address - Street 2:
Mailing Address - City:DELTA JUNCTION
Mailing Address - State:AK
Mailing Address - Zip Code:99737-9501
Mailing Address - Country:US
Mailing Address - Phone:907-895-5528
Mailing Address - Fax:907-895-5528
Practice Address - Street 1:HC 62 BOX 5386
Practice Address - Street 2:
Practice Address - City:DELTA JUNCTION
Practice Address - State:AK
Practice Address - Zip Code:99737-9501
Practice Address - Country:US
Practice Address - Phone:907-895-5528
Practice Address - Fax:907-895-5528
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK775363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK160058Medicaid
AKNP97931Medicaid