| Doctor Name: | ALYSSA DEDMON |
| NPI Number: | 1295116770 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 5007666 |
| Business Practice Address: | 112 Oak St Cherryville, NC - 280213423 |
| Business Phone Number: | 9804872200 |
| Business Fax Number: | 7044353295 |
| Mailing Address: | Po Box 601884, CHARLOTTE |
| State: | NC |
| Postal Code: | 282601884 |
| Phone Number: | 9804872200 |
| Fax Number: | 7044353295 |
| NPI Enumeration Date: | 06/10/2015 |
| NPI Last Update Date: | 02/16/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 5007666 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |