MEDICARE: ALEXCEA A DEBRUCE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	LAT-5839	NC

General Provider Information

NPI Number	:	1033815089
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXCEA A DEBRUCE

Provider Business Mailing Address
First Line	:	127 JONESHAVEN DR
Second Line	:
City	:	FUQUAY VARINA
State	:	NC
Zip	:	27526-4333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2495 RAY RD
Second Line	:
City	:	SPRING LAKE
State	:	NC
Zip	:	28390-7531
Country	:	US
Telephone Number	:	910-551-0511
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2023
Last Update Date	:	05/11/2026

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Directions to “ ALEXCEA A DEBRUCE ” Practice Location

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