Individual
CASEY BERRY RIDGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
460 CLEMSON RD, COLUMBIA, SC 29229-7925
(803) 438-3800
Mailing address
378 FANNIE BLACK RD, PROSPERITY, SC 29127-6943
(803) 603-7676
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
25903
SC
Other
Enumeration date
04/12/2022
Last updated
01/24/2024
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