Provider Demographics
NPI:1821558875
Name:WEEKS, OPHELIA DIANNE (CNA)
Entity Type:Individual
Prefix:
First Name:OPHELIA
Middle Name:DIANNE
Last Name:WEEKS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4022 ULMER RD APT 503
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-3356
Mailing Address - Country:US
Mailing Address - Phone:803-724-7969
Mailing Address - Fax:
Practice Address - Street 1:4022 ULMER RD APT 503
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-3356
Practice Address - Country:US
Practice Address - Phone:803-724-7969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-24
Last Update Date:2019-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health