Individual
AMY RUTH RAVENSCRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 PATEWOOD DR STE A200, GREENVILLE, SC 29615-3580
(886) 445-4511
(864) 454-5115
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2993
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006007465
NP CERTIFICATION
MD
05
—
NP1065
—
SC
Enumeration date
02/01/2007
Last updated
05/11/2021
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