MEDICARE: KYLE ANTHONY USSERY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	RN304569	GA

General Provider Information

NPI Number	:	1902764046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYLE ANTHONY USSERY

Provider Business Mailing Address
First Line	:	2132 FAIRWAY CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-3827
Country	:	US
Telephone Number	:	678-367-9215
Fax Number	:

Provider Business Practice Location Address
First Line	:	2132 FAIRWAY CIR NE
Second Line	:
City	:	BROOKHAVEN
State	:	GA
Zip	:	30319-3827
Country	:	US
Telephone Number	:	678-367-9215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2026
Last Update Date	:	01/15/2026

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Directions to “ KYLE ANTHONY USSERY ” Practice Location

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