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Kelly B St. George, FNP

Nurse Practitioner, Family in Charlotte, NC. Individual provider (NPI-1).

NPI number1881900595
StatusActive
Last updated in NPPESSep 25, 2025

Details

NPI
1881900595
Entity type
Individual (NPI-1)
Name
Kelly B St. George
Credential
FNP
Sex
Female
Sole proprietor
No
Enumeration date
Aug 19, 2010
Last updated
Sep 25, 2025

Medicare and OIG

Medicare enrolled (PECOS)
Yes · PRACTITIONER - NURSE PRACTITIONER
Can order and refer
Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family5004843NCYes
363L00000X Nurse Practitioner5004843NC

Practice location

10620 Park Rd
Ste 202
Charlotte, NC 28210-8472

Phone 704-667-0920

Mailing address

Po Box 19305
Charlotte, NC 28219-9305

Other practice locations

2301 Us Highway 74 W
Wadesboro, NC 28170-7554

Phone 704-994-4500

1000 Blythe Blvd
Charlotte, NC 28203-5812

Phone 704-355-2000

1100 Blythe Blvd
Charlotte, NC 28203-5814

Phone 704-355-4300

201 E Grover St
Shelby, NC 28150-3917

Phone 980-487-3000

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Nurse Practitioner providers in Charlotte, NC

All 646 Family Nurse Practitioner providers in Charlotte · All 32,379 providers in Charlotte

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