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NPI Code Detail

MEDICARE: KRISTIN MARIE GEORGE RN

MEDICARE: KRISTIN MARIE GEORGE RN
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
1163W00000XRegistered Nurse201041962OR

General Provider Information

NPI Number : 1376480194
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN MARIE GEORGE RN
Provider Business Mailing Address
First Line : 1120 W AMANDA ST
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1148
Country : US
Telephone Number : 541-677-3360
Fax Number :
Provider Business Practice Location Address
First Line : 2700 NW STEWART PKWY
Second Line :
City : ROSEBURG
State : OR
Zip : 97471-1214
Country : US
Telephone Number : 541-677-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2026
Last Update Date : 04/30/2026

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