Healthcare Provider Details

I. General information

NPI: 1104551787
Provider Name (Legal Business Name): BRITTANY RUGGERI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 E CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

365 HARBOUR VIEW DR
MYRTLE BEACH SC
29579-7450
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-5621
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26306
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11031876
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: