Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Marybeth Daria Fazio, APRN

Individual provider Family Nurse Practitioner · NPI 1811721335

Marybeth Daria Fazio, APRN is a Nurse Practitioner in Conyers, Georgia. Qualified in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
2
Licensed in
GA
In the registry since
2024
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

2860 Bridle Creek Dr SW
Conyers, GA 30094-5677
Phone: (404) 538-0266
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN078153 (GA)

Record details

NPI number1811721335
Entity typeIndividual (Type 1)
GenderFemale
Credentials APRN
Sole proprietorYes
NPI enumeratedAugust 27, 2024
Last updated in NPPESAugust 27, 2024
Certification dateAugust 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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