Healthcare Provider Details

I. General information

NPI: 1659285476
Provider Name (Legal Business Name): ALYSSA MORLE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 YORKTOWN DR STE 208
FAYETTEVILLE GA
30214-1578
US

IV. Provider business mailing address

101 YORKTOWN DR STE 208
FAYETTEVILLE GA
30214-1578
US

V. Phone/Fax

Practice location:
  • Phone: 770-460-4283
  • Fax:
Mailing address:
  • Phone: 770-460-4283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP294701
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: