Healthcare Provider Details

I. General information

NPI: 1144302746
Provider Name (Legal Business Name): RHONDA WELLMAN DEPASQUALE CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA WELLMAN DEPASQUALE CRNA

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2131 S 17TH ST
WILMINGTON NC
28401-7407
US

IV. Provider business mailing address

4601 KANAWHA AVE SE C
CHARLESTON WV
25304
US

V. Phone/Fax

Practice location:
  • Phone: 910-343-7000
  • Fax:
Mailing address:
  • Phone: 304-925-0625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number44332
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number6519
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number38023
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: