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General NPI Number Information
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NPI Number | 1154225563
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Entity Type | Organization
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Legal Business Name | MOMENTUM HEALTH AND WELLNESS, PLLC
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Dates
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Enumeration Date | 10/07/2026
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Last Update Date | 10/07/2026
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Provider Practice Location Address
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Address Line | 1312 N FAYETTEVILLE ST
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City | ASHEBORO
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State | NC
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Zip | 27203-3920
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Country | US
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Telephone | 336-318-5572
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Fax |
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Provider Business Mailing Address
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Address Line | 100 HOMEPLACE DR
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City | RANDLEMAN
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State | NC
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Zip | 27317-9600
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Country | US
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Telephone | 336-318-5572
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Fax |
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Authorized Official
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Title or Position | FNP-C
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Name | JACQUELINE KING
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Credential |
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Telephone | 336-318-5572
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | NULL
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