Individual
SHARON L FASSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Mailing address
5777 E MAYO BLVD, PHOENIX, AZ 85054-4502
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN121661
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
766553
—
AZ
01
—
P00007254
RAILROAD MEDICARE
AZ
Enumeration date
12/01/2005
Last updated
10/29/2007
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