Provider Demographics
NPI:1750848206
Name:BARTEE, BERNADETTE TRICHELLE
Entity Type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:TRICHELLE
Last Name:BARTEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2655 SHORELINE DR APT A12
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-1275
Mailing Address - Country:US
Mailing Address - Phone:330-907-2551
Mailing Address - Fax:
Practice Address - Street 1:2655 SHORELINE DR
Practice Address - Street 2:APT A 12
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-1275
Practice Address - Country:US
Practice Address - Phone:330-907-2551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRP600399172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty