Healthcare Provider Details

I. General information

NPI: 1104548718
Provider Name (Legal Business Name): SHANNON HESTER ALLEY DNP,FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 REGIONAL DR STE D
PINEHURST NC
28374-9868
US

IV. Provider business mailing address

4731 CENTER RD
BLADENBORO NC
28320-8279
US

V. Phone/Fax

Practice location:
  • Phone: 910-221-7195
  • Fax: 910-660-0984
Mailing address:
  • Phone: 910-874-0491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019304
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: