Healthcare Provider Details

I. General information

NPI: 1154643898
Provider Name (Legal Business Name): SARAH ALLEN FAZEKAS FNPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SARAH ALLEN MCDONALD FNP

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S MAIN ST
RAEFORD NC
28376-3222
US

IV. Provider business mailing address

405 S MAIN ST
RAEFORD NC
28376-3222
US

V. Phone/Fax

Practice location:
  • Phone: 910-615-5800
  • Fax: 910-875-0309
Mailing address:
  • Phone: 910-323-1718
  • Fax: 910-323-5701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201341
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number138939
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: