ARDELEAN, RHONDA SUE (PA)

Provider Demographics

• NPI: 1174552020
• Name: ARDELEAN, RHONDA SUE (PA)
• Entity type: Individual
• First Name: RHONDA
• Middle Name: SUE
• Last Name: ARDELEAN
• Gender: F
• Credentials: PA
• Mailing Address - Street 1: PO BOX 19305
• Mailing Address - City: CHARLOTTE
• Mailing Address - State: NC
• Mailing Address - Zip Code: 28219-9305
• Mailing Address - Country: US
• Practice Address - Street 1: 15110 JOHN J DELANEY DR
• Practice Address - Street 2: STE 200
• Practice Address - City: CHARLOTTE
• Practice Address - State: NC
• Practice Address - Zip Code: 28277-3544
• Practice Address - Country: US
• Practice Address - Phone: 704-302-8100
• Is Sole Proprietor?: No
• Enumeration Date: 2006-07-02
• Last Update Date: 2024-07-15

Provider Licenses

State	License ID	Taxonomies
NC	0010-00642	363A00000X, 363A00000X
CA	PA14021	363A00000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant

Provider Identifiers

State	Identifier ID	ID Type	Issuer
SC	1407PA	Medicaid
CA	PA14021	Medicaid
NC	0001000642	Other	NC LICENSE
NC	8101164	Medicaid
NC	1174552020	Medicaid
NC	2762818H	Medicare PIN
NC	2768003D	Medicare PIN
CA	P40823	Medicare UPIN
NC	2768003N	Medicare PIN
SC	AA86787772	Medicare PIN
NC	2762818	Medicare PIN
NC	8101164	Medicaid
NC	1174552020	Medicaid
CA	WPA14021B	Medicare PIN
NC	2768003B	Medicare PIN
NC	2768003L	Medicare PIN
NC	NC4534B	Medicare PIN
NC	2762818D	Medicare PIN
SC	1407PA	Medicaid
NC	2762818P	Medicare PIN
NC	2762818F	Medicare PIN
NC	2762818L	Medicare PIN
NC	2768003T	Medicare PIN
NC	2762818C	Medicare PIN
NC	0001000642	Other	NC LICENSE
NC	2762818K	Medicare PIN
NC	2768003E	Medicare PIN
NC	2762818A	Medicare PIN