| Doctor Name: | MRS. RUTH ANNE ETTER |
| NPI Number: | 1003243056 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP-BC |
| License Number: | 18468 |
| Business Practice Address: | 2210 Laurens Rd Greenville, SC - 296073224 |
| Business Phone Number: | 8642888292 |
| Business Fax Number: | |
| Mailing Address: | 1300 Tiger Blvd, CLEMSON |
| State: | SC |
| Postal Code: | 296311114 |
| Phone Number: | 8646536724 |
| Fax Number: | |
| NPI Enumeration Date: | 10/06/2013 |
| NPI Last Update Date: | 08/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 18468 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | SC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |