Individual
DARRELL LEROY WOLFE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1103273
KY
367500000X
Certified Registered Nurse Anesthetist
Primary
006930
WV
367500000X
Certified Registered Nurse Anesthetist
054720
KY
367500000X
Certified Registered Nurse Anesthetist
07240
OH
367500000X
Certified Registered Nurse Anesthetist
APN0000010406
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000540386
ANTHEM
—
01
—
1073324
BRICKSTREET
WV
05
—
200253980
—
IN
05
—
2376263
—
OH
05
—
7400958000
—
KY
Enumeration date
10/09/2005
Last updated
06/04/2021
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