Individual
EKATERINA MAKSIMOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
701 GROVE RD, GREENVILLE, SC 29605-4210
(864) 455-7000
Mailing address
165 RUSHING WATERS DR, INMAN, SC 29349-6787
(864) 357-7133
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
234079
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
149140
SC
367500000X
Certified Registered Nurse Anesthetist
28799
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/25/2023
Last updated
06/05/2024
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