Provider Demographics
NPI:1417349572
Name:REED, REBECCA RUFF (FNP-BC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:RUFF
Last Name:REED
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:REBECCA
Other - Last Name:REED
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 6069
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29171-6069
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2728 SUNSET BLVD STE 104
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-4838
Practice Address - Country:US
Practice Address - Phone:803-256-0464
Practice Address - Fax:803-254-5121
Is Sole Proprietor?:No
Enumeration Date:2015-02-26
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19328363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily