Provider Demographics
NPI:1720495252
Name:WEISZ, ANDREA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:WEISZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ANDREA
Other - Middle Name:
Other - Last Name:RICHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:321 MAIN ST W
Mailing Address - Street 2:
Mailing Address - City:HAZEN
Mailing Address - State:ND
Mailing Address - Zip Code:58545-4211
Mailing Address - Country:US
Mailing Address - Phone:701-880-0027
Mailing Address - Fax:701-938-4541
Practice Address - Street 1:726 80TH AVE NW
Practice Address - Street 2:THREE AFFILIATED TRIBES TWIN BUTTES FIELD CLINIC
Practice Address - City:HALLIDAY
Practice Address - State:ND
Practice Address - Zip Code:58636-4001
Practice Address - Country:US
Practice Address - Phone:701-938-4540
Practice Address - Fax:701-938-4541
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2017-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR28982363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily