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General NPI Number Information
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NPI Number | 1215691720
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Entity Type | Individual
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Provider Name | IRINA SURZHUKOV MISHLER APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 10/30/2021
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Last Update Date | 08/22/2025
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Provider Practice Location Address
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Address Line | 101 E WOOD ST STE 401
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City | SPARTANBURG
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State | SC
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Zip | 29303-3040
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Country | US
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Telephone | 864-560-6654
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Fax | 864-560-7353
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Provider Business Mailing Address
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Address Line | PO BOX 743070
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City | ATLANTA
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State | GA
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Zip | 30374-3070
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Country | US
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Telephone | 864-560-4304
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Fax | 864-560-4413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 25537
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License Number State | SC
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