Provider Demographics
NPI:1629618467
Name:CSERNIK, RACHEL ANN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ANN
Last Name:CSERNIK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:RACHEL
Other - Middle Name:ANN
Other - Last Name:ROSCOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2951 MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701
Mailing Address - Country:US
Mailing Address - Phone:740-450-6148
Mailing Address - Fax:330-286-5396
Practice Address - Street 1:2951 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701
Practice Address - Country:US
Practice Address - Phone:740-450-6148
Practice Address - Fax:330-286-5396
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN403020163W00000X
OH129053367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHPENDINGOtherMEDICARE PTAN
OHPENDINGMedicaid