Healthcare Provider Details

I. General information

NPI: 1356045132
Provider Name (Legal Business Name): AVERY NICOLE FAUCETTE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DUKE HEALTH CARY PL
CARY NC
27519-6759
US

IV. Provider business mailing address

2301 ERWIN RD
DURHAM NC
27705-4699
US

V. Phone/Fax

Practice location:
  • Phone: 919-385-4650
  • Fax:
Mailing address:
  • Phone: 919-684-8111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2026-01608
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: