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General NPI Number Information
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NPI Number | 1932700465
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Entity Type | Individual
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Provider Name | LARISA SOPKA RN
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Gender | Female
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Dates
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Enumeration Date | 11/02/2020
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 17931 SARATOGA TRL
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City | STRONGSVILLE
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State | OH
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Zip | 44136-7229
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Country | US
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Telephone | 216-262-3173
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61246495
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 326528
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License Number State | OH
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