MEDICARE: CAROLE L GEORGE MSN, BC-ACNS, CDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	364SA2200X	Adult Health Clinical Nurse Specialist	648547	TX

General Provider Information

NPI Number	:	1023250420
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLE L GEORGE MSN, BC-ACNS, CDE

Provider Business Mailing Address
First Line	:	6500 N MO PAC EXPY
Second Line	:	BLDG. 3, SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78731-3282
Country	:	US
Telephone Number	:	512-458-8400
Fax Number	:	512-458-8593

Provider Business Practice Location Address
First Line	:	6500 N MO PAC EXPY
Second Line	:	BLDG. 3, SUITE 200
City	:	AUSTIN
State	:	TX
Zip	:	78731-3282
Country	:	US
Telephone Number	:	512-458-8400
Fax Number	:	512-458-8593

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2009
Last Update Date	:	05/18/2011

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