MEDICARE: MRS. RUTH CROSBY WALKUP PMHNP-BC, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	5004036	NC
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	5004036	NC
3	363LF0000X	Family Nurse Practitioner	2561	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134285448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUTH CROSBY WALKUP PMHNP-BC, FNP-BC

Provider Business Mailing Address
First Line	:	1820 WILLARD CT
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-7727
Country	:	US
Telephone Number	:	984-283-0333
Fax Number	:	984-283-0433

Provider Business Practice Location Address
First Line	:	3440 TORINGDON WAY STE 205
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28277-3191
Country	:	US
Telephone Number	:	980-375-6657
Fax Number	:	980-375-6658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	02/09/2026

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