Healthcare Provider Details

I. General information

NPI: 1033817135
Provider Name (Legal Business Name): ALISA MENN RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALISA HEPPE

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 PEACHTREE DUNWOODY RD STE 600
SANDY SPRINGS GA
30342-2095
US

IV. Provider business mailing address

5673 PEACHTREE DUNWOODY RD STE 600
ATLANTA GA
30342-2095
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-4111
  • Fax:
Mailing address:
  • Phone: 404-400-9724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN283697
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: