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Individual

RUSTY RYAN CREIGHTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
TAYLOR AT MARION STREETS, PALMETTO HEALTH BAPTIST, COLUMBIA, SC 29201
(803) 296-2548
(803) 296-2548
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2625
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AN1411
SC
Enumeration date
03/07/2006
Last updated
03/10/2022
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