Healthcare Provider Details

I. General information

NPI: 1073399366
Provider Name (Legal Business Name): NOELLE GAITHER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 S PARK ST
ASHEBORO NC
27203-5651
US

IV. Provider business mailing address

136 S PARK ST
ASHEBORO NC
27203-5651
US

V. Phone/Fax

Practice location:
  • Phone: 336-626-6371
  • Fax: 336-629-0436
Mailing address:
  • Phone: 336-626-6371
  • Fax: 336-629-0436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019491
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019491
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number378845
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: