Individual
AMANDA TIPTON LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 522-2286
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-2286
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
2008011702
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
23844
SC
Other
Enumeration date
09/22/2015
Last updated
12/27/2023
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