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NPI 1295680346

NPI 1295680346 : EBONY MUNSON RD, LDN, CDCES : STEM, NC

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General NPI Number Information
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    NPI Number           |    1295680346
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    Entity Type          |    Individual 
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    Provider Name        |    EBONY MUNSON RD, LDN, CDCES
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    Gender               |     
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Dates
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    Enumeration Date     |    03/03/2026
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    Last Update Date     |    03/03/2026
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Provider Practice Location Address
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    Address Line         |    211 RICHMOND RUN 
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    City                 |    STEM
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    State                |    NC
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    Zip                  |    27581-9010
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    Country              |    US
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    Telephone            |    912-977-3839
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    211 RICHMOND RUN 
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    City                 |    STEM
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    State                |    NC
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    Zip                  |    27581-9010
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    Country              |    US
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    Telephone            |    912-977-3839
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    978336
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    License Number State |    NC
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