Individual
KELLY B ST. GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
10620 PARK RD, STE 202, CHARLOTTE, NC 28210-8472
(704) 667-0920
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5004843
NC
363LF0000X
Family Nurse Practitioner
Primary
5004843
NC
Other
Enumeration date
08/19/2010
Last updated
09/25/2025
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