Healthcare Provider Details
I. General information
NPI: 1184575029
Provider Name (Legal Business Name): MRS. RUTH ANN BREWER TOPPER
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/06/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
139 TALL PINES RD
FOUNTAIN INN SC
29644-9712
US
IV. Provider business mailing address
139 TALL PINES RD
FOUNTAIN INN SC
29644-9712
US
V. Phone/Fax
- Phone: 864-915-0384
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LN0000X |
| Taxonomy | Neonatal Nurse Practitioner |
| License Number | 31973 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: