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General NPI Number Information
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NPI Number | 1952399545
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Entity Type | Individual
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Provider Name | DARRELL LEROY WOLFE JR. CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/09/2005
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 1400 HOSPITAL DR
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City | HURRICANE
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State | WV
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Zip | 25526-9202
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Country | US
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Telephone | 304-346-9400
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Fax | 304-345-7320
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Provider Business Mailing Address
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Address Line | PO BOX 711841
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City | COLUMBUS
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State | OH
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Zip | 43271-0001
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Country | US
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Telephone | 304-346-9400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1103273
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | APN0000010406
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 07240
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 054720
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 006930
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License Number State | WV
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