Healthcare Provider Details

I. General information

NPI: 1558937326
Provider Name (Legal Business Name): ERICA RUTLEDGE SAINT-PREUX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2021
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 GREEN ST
COLUMBIA SC
29208-2857
US

IV. Provider business mailing address

1601 GREENE ST
COLUMBIA SC
29208-4001
US

V. Phone/Fax

Practice location:
  • Phone: 803-777-7412
  • Fax:
Mailing address:
  • Phone: 803-777-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number219743
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: