Individual
CHRYSTAL LEVERN RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10 ENTERPRISE BLVD STE 109, GREENVILLE, SC 29615-3534
(864) 458-7141
(864) 676-9116
Mailing address
104 MISTY LN, BELTON, SC 29627-9576
(864) 940-1250
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
103315
SC
363LF0000X
Family Nurse Practitioner
Primary
27927
SC
Other
Enumeration date
08/31/2023
Last updated
09/22/2023
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