Individual
MIRANDA COBB MIZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
7 INDEPENDENCE PT STE 300, GREENVILLE, SC 29615-4569
(864) 522-3700
(864) 522-3705
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN 3454
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1649
—
SC
Enumeration date
01/15/2008
Last updated
01/24/2022
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