Provider Demographics
NPI:1710940606
Name:ZOCCOLE, ROSLYN (CRNA)
Entity Type:Individual
Prefix:
First Name:ROSLYN
Middle Name:
Last Name:ZOCCOLE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ROSLYN
Other - Middle Name:
Other - Last Name:CORTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2536 FAWN VALLEY
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317
Mailing Address - Country:US
Mailing Address - Phone:724-746-2554
Mailing Address - Fax:
Practice Address - Street 1:740 E STATE ST
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3328
Practice Address - Country:US
Practice Address - Phone:724-617-5627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN-272610-L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
S07390Medicare UPIN