Healthcare Provider Details

I. General information

NPI: 1922367200
Provider Name (Legal Business Name): SOPHIA K WEINRICH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2012
Last Update Date: 05/01/2017
Certification Date:
Deactivation Date: 07/18/2012
Reactivation Date: 02/17/2015

III. Provider practice location address

3221 RANIER AVENUE
COLUMBUS OH
43231-3125
US

IV. Provider business mailing address

3221 RAINIER AVE
COLUMBUS OH
43231-3144
US

V. Phone/Fax

Practice location:
  • Phone: 614-598-0060
  • Fax:
Mailing address:
  • Phone: 614-598-0060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number400385090704
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number158474
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: