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General NPI Number Information
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NPI Number | 1841139524
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Entity Type | Organization
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Legal Business Name | SOLAIRE INTEGRATIVE HEALTH
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Dates
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Enumeration Date | 03/26/2026
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Last Update Date | 03/26/2026
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Provider Practice Location Address
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Address Line | 4343 SHALLOWFORD RD STE 540
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City | MARIETTA
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State | GA
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Zip | 30062-5071
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Country | US
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Telephone | 770-405-1249
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Fax |
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Provider Business Mailing Address
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Address Line | 8 PERIMETER CTR E APT 1414
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City | ATLANTA
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State | GA
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Zip | 30346-1676
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | JACKIE BASSONG
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Credential | FNP-C
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Telephone | 678-896-3122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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