Individual
MICHELLE E RUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
85993
SC
367500000X
Certified Registered Nurse Anesthetist
079697
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
3576
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1715
—
SC
Enumeration date
05/09/2008
Last updated
02/10/2022
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