Healthcare Provider Details

I. General information

NPI: 1295316792
Provider Name (Legal Business Name): ALLEGIANCE ANESTHESIA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 04/16/2021
Certification Date: 03/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 SANDHURST DR
FAYETTEVILLE NC
28304-4426
US

IV. Provider business mailing address

837 JUDSON CHURCH RD
FAYETTEVILLE NC
28312-9280
US

V. Phone/Fax

Practice location:
  • Phone: 910-339-8475
  • Fax:
Mailing address:
  • Phone: 910-987-1343
  • Fax: 910-425-3077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MRS. SHARON ELIZABETH TAYLOR
Title or Position: 0WNER/PRESIDENT
Credential: CRNA
Phone: 910-987-1343