Individual
MARVO BRENDA PROSPER AZILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4104 ELDON DR, FAIRBURN, GA 30213-5806
(470) 443-7128
Mailing address
4104 ELDON DR, FAIRBURN, GA 30213-5806
(470) 443-7128
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN320202
GA
Other
Enumeration date
03/26/2026
Last updated
03/26/2026
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