Provider Demographics
NPI:1154643898
Name:FAZEKAS, SARAH ALLEN (FNPC)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:ALLEN
Last Name:FAZEKAS
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:ALLEN
Other - Last Name:MCDONALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:405 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-3222
Mailing Address - Country:US
Mailing Address - Phone:910-323-1718
Mailing Address - Fax:910-323-5701
Practice Address - Street 1:405 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-3222
Practice Address - Country:US
Practice Address - Phone:910-615-5800
Practice Address - Fax:910-875-0309
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201341363LF0000X
NC138939363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily