Individual
LEAH SOPKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
38429 LAKE SHORE BLVD, WILLOUGHBY, OH 44094-7009
(440) 269-7488
Mailing address
38429 LAKE SHORE BLVD, WILLOUGHBY, OH 44094-7009
(440) 269-7488
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
COA.12361-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0057603
—
OH
Enumeration date
08/19/2011
Last updated
11/13/2012
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