Healthcare Provider Details

I. General information

NPI: 1003813163
Provider Name (Legal Business Name): ROSEANN M CHERNEK R.N.F.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSEANN M STAFFORD R.N.

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 EASTWIND DR
WESTERVILLE OH
43081-3376
US

IV. Provider business mailing address

955 EASTWIND DR
WESTERVILLE OH
43081-3376
US

V. Phone/Fax

Practice location:
  • Phone: 614-268-9561
  • Fax: 614-268-7849
Mailing address:
  • Phone: 614-268-9561
  • Fax: 614-268-7849

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN146908
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: