Provider Demographics
NPI:1265669766
Name:ROLINSKI COCHRAN, MARIA (CRNA)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ROLINSKI COCHRAN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7630 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5633
Mailing Address - Country:US
Mailing Address - Phone:330-729-8000
Mailing Address - Fax:
Practice Address - Street 1:7630 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512
Practice Address - Country:US
Practice Address - Phone:330-758-1954
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN511943L367500000X
OHAPRN.CRNA.11181367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2969408Medicaid
OH8246911OtherMEDICARE PTAN