Provider Demographics
NPI:1740845916
Name:GLASSTETTER, ERIC J (CRNA)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:J
Last Name:GLASSTETTER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5151 REED RD STE 225C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2553
Mailing Address - Country:US
Mailing Address - Phone:614-884-0641
Mailing Address - Fax:614-884-0776
Practice Address - Street 1:3535 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3908
Practice Address - Country:US
Practice Address - Phone:614-566-4919
Practice Address - Fax:614-566-6993
Is Sole Proprietor?:No
Enumeration Date:2019-05-03
Last Update Date:2019-06-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.019892367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered