Provider Demographics
NPI:1659850212
Name:GEORGE, CLAUDINE ROWENA (DNP/ARNP)
Entity Type:Individual
Prefix:DR
First Name:CLAUDINE
Middle Name:ROWENA
Last Name:GEORGE
Suffix:
Gender:F
Credentials:DNP/ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4574 SW TABOR ST
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6740
Mailing Address - Country:US
Mailing Address - Phone:772-626-1002
Mailing Address - Fax:
Practice Address - Street 1:4574 SW TABOR ST
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6740
Practice Address - Country:US
Practice Address - Phone:772-626-1002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-14
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9261736363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty