Healthcare Provider Details

I. General information

NPI: 1285977355
Provider Name (Legal Business Name): ALYSSA LAUREN KESSELMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2013
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2174 N. DRUID HILLS RD NE VASCULAR ANOMALIES CLINIC
ATLANTA GA
30329
US

IV. Provider business mailing address

2174 N. DRUID HILLS RD NE VASCULAR ANOMALIES CLINIC
ATLANTA GA
30329
US

V. Phone/Fax

Practice location:
  • Phone: 404-785-8839
  • Fax: 404-553-9772
Mailing address:
  • Phone: 404-785-8839
  • Fax: 404-553-9772

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN-NP201497
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberRN201497
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: