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NPI Code Detail

MEDICARE: KRISTIN MICHELLE GEORGE

MEDICARE:   KRISTIN MICHELLE GEORGE
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
1347E00000XTransportation Broker0120517TN

General Provider Information

NPI Number : 1386249969
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN MICHELLE GEORGE
Provider Business Mailing Address
First Line : 3099 BUCHANAN RD SE APT 212
Second Line :
City : CLEVELAND
State : TN
Zip : 37323-3120
Country : US
Telephone Number : 423-284-8462
Fax Number :
Provider Business Practice Location Address
First Line : 3099 BUCHANAN RD SE APT 212
Second Line :
City : CLEVELAND
State : TN
Zip : 37323-3120
Country : US
Telephone Number : 904-330-7479
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2020
Last Update Date : 12/02/2020

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Directions to “ KRISTIN MICHELLE GEORGE ” Practice Location

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