MEDICARE: MRS. KATRINA AUBRIEANA GEORGE MSN, CNM, IBCLC

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	367A00000X	Advanced Practice Midwife	677	NC
2	367A00000X	Advanced Practice Midwife

General Provider Information

NPI Number	:	1437658473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATRINA AUBRIEANA GEORGE MSN, CNM, IBCLC

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	129 GREENWICH RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2313
Country	:	US
Telephone Number	:	704-266-6454
Fax Number	:	618-360-7524

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

Provider Enumeration Date	:	02/05/2018
Last Update Date	:	06/16/2026

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