Provider Demographics
NPI:1922367200
Name:WEINRICH, SOPHIA K
Entity Type:Individual
Prefix:
First Name:SOPHIA
Middle Name:K
Last Name:WEINRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3221 RAINIER AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-3144
Mailing Address - Country:US
Mailing Address - Phone:614-598-0060
Mailing Address - Fax:
Practice Address - Street 1:3221 RANIER AVENUE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-3125
Practice Address - Country:US
Practice Address - Phone:614-598-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2017-05-01
Deactivation Date:2012-07-18
Deactivation Code:
Reactivation Date:2015-02-17
Provider Licenses
StateLicense IDTaxonomies
OH158474164W00000X
OH400385090704376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No376K00000XNursing Service Related ProvidersNurse's Aide