Addison Tate Debord
Student in an Organized Health Care Education/Training Program in Monroe, NC. Individual provider (NPI-1).
NPI number1548063142
StatusActive
Last updated in NPPESSep 5, 2026
Details
- NPI
- 1548063142
- Entity type
- Individual (NPI-1)
- Name
- Addison Tate Debord
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 29, 2025
- Certification date
- Sep 5, 2026
- Last updated
- Sep 5, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
| 208D00000X | General Practice | 2026-04160 | NC |
Practice location
1106 Reynolds St Ste 100Monroe, NC 28112-4376
Phone 704-289-5443
Mailing address
1106 Reynolds St Ste 100Monroe, NC 28112-4376
Phone 704-289-5443
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Other Student in an Organized Health Care Education/Training Program providers in Monroe, NC
- Morgan Carlson, DONPI 1376246330
- Lakshmi Hasitha ChennuNPI 1710734652
- Tara Nicole CoadyNPI 1356082499
- Madison Audrey DulisNPI 1477305167
- Alexander Smith HamadNPI 1528765021
- Ashley Breanne Karow, MED., NCCNPI 1336418466
- Kristopher Brandon-Paul Latour, MDNPI 1548964778
- Kali Marie MalhamNPI 1770330011
- Francisco Alberto Matos Quintero, MDNPI 1679215826
- Jaklyn Drew McCauley, DONPI 1225978091
All 19 Student in an Organized Health Care Education/Training Program providers in Monroe · All 1,733 providers in Monroe
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