Provider Demographics
NPI:1003813163
Name:CHERNEK, ROSEANN M (RNFA)
Entity Type:Individual
Prefix:
First Name:ROSEANN
Middle Name:M
Last Name:CHERNEK
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:ROSEANN
Other - Middle Name:M
Other - Last Name:STAFFORD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:955 EASTWIND DR
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-3376
Mailing Address - Country:US
Mailing Address - Phone:614-268-9561
Mailing Address - Fax:614-268-7849
Practice Address - Street 1:955 EASTWIND DR
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-3376
Practice Address - Country:US
Practice Address - Phone:614-268-9561
Practice Address - Fax:614-268-7849
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN146908163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000337078OtherANTHEM PIN