PROVIDENCE PEDIATRIC FUNCTIONAL MEDICINE, PLLC
NPI 1710810437
Clinic/Center - Primary Care in Asheboro, NC
Active since June 03, 2026
About Providence Pediatric Functional Medicine, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE PEDIATRIC FUNCTIONAL MEDICINE, PLLC (NPI 1710810437) is a healthcare organization registered as a primary care in Asheboro, North Carolina and active in the NPI registry since June 2026. The organization lists Nicole Anderson, Owner/authorized Offician, as its authorized official.
NPPES Registry Identity
NPI1710810437
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NamePROVIDENCE PEDIATRIC FUNCTIONAL MEDICINE, PLLC
Location Address610 N FAYETTEVILLE ST STE 102Asheboro, NC 27203-4671
Mailing Address610 N Fayetteville St Ste 102Asheboro, NC 27203-4671 · (336) 233-7882
Phone(336) 233-7882
Organization SubpartNo
Authorized OfficialNicole AndersonOwner/authorized Offician · (336) 233-7882
Enumeration DateJune 3, 2026
Last NPPES UpdateJune 6, 2026
NPPES CertifiedJune 6, 2026
✔ NPI 1710810437 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
610 N FAYETTEVILLE ST STE 102, Asheboro, NC 27203
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1710810437, enumerated as an "organization" on June 03, 2026.
The provider is located at 610 N FAYETTEVILLE ST STE 102 ASHEBORO, NC 27203 and the phone number is (336) 233-7882.
Clinic/Center with taxonomy code 261QP2300X and a focus in Primary Care.
