Mackenzie J Weis
Mackenzie J Weis is a Physician Assistant in South Haven, Minnesota. Qualified in 2025, 1 year ago. Practices with Centracare Clinic, a 782-clinician group and accepts Medicare assignment. Licensed in Minnesota.
- Years since qualifying
- 1
- Licensed in
- MN
- In the registry since
- 2025
- Specialties on file
- 2
Practice location Address checks out
306 149th StSouth Haven, MN 55382-9140
Phone: (320) 291-0229
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X · Licence 15408 (MN) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1104636547 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | January 8, 2025 |
| Last updated in NPPES | July 2, 2025 |
| Certification date | July 2, 2025 |
| Mailing address | 306 149th St, South Haven, MN 55382-9140 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2025 (1 years in practice) |
| Group practice | Centracare Clinic — 782 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 6 on file with Medicare |