Individual
MARK MIZUBA
Active
Individual
MARK MIZUBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024166707
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010218608
—
VA
05
—
010218632
—
VA
05
—
010218641
—
VA
05
—
010218705
—
VA
05
—
010218748
—
VA
Enumeration date
08/02/2006
Last updated
12/22/2025
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