Individual provider · Type 1 NPI

Addison Tate Debord

Student in an Organized Health Care Education/Training Program · Monroe, NC

NPI number 1548063142 Active

Practice location

1106 Reynolds St Ste 100
Monroe, NC 28112-4376

Call (704) 289-5443 Map

Specialties and licenses

TaxonomyCodeLicense
General Practice Physician 208D00000X2026-04160 (NC)
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1548063142

Addison Tate Debord's National Provider Identifier is 1548063142, issued on Mar 29, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Monroe, NC. The record was last updated on Sep 5, 2026.