Provider Demographics
NPI:1659783355
Name:PARTLOW, BICETTA (CRNA)
Entity Type:Individual
Prefix:
First Name:BICETTA
Middle Name:
Last Name:PARTLOW
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 1:6006 PLUMB RD
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9710
Mailing Address - Country:US
Mailing Address - Phone:614-352-3481
Mailing Address - Fax:
Practice Address - Street 1:5151 REED RD
Practice Address - Street 2:SUITE 225-C
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-2595
Practice Address - Country:US
Practice Address - Phone:614-457-2306
Practice Address - Fax:614-884-0776
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016864367500000X
OHCOA16012NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN301687OtherOHIO LICENSE
OH0104903Medicaid
OHP01338266OtherRAILROAD MEDICARE
OHCOA16012NAOtherCRNA LICENSE
OHP01338266OtherRAILROAD MEDICARE