Provider Demographics
NPI:1861735904
Name:WEIS, ERIN K
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:K
Last Name:WEIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 N CRUSEY ST STE B101
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7101
Mailing Address - Country:US
Mailing Address - Phone:907-746-3445
Mailing Address - Fax:907-746-3439
Practice Address - Street 1:777 N CRUSEY ST STE B101
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7101
Practice Address - Country:US
Practice Address - Phone:907-746-3445
Practice Address - Fax:907-746-3439
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator