MEDICARE: SOLAIRE INTEGRATIVE HEALTH

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	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1841139524
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOLAIRE INTEGRATIVE HEALTH

Provider Business Mailing Address
First Line	:	8 PERIMETER CTR E APT 1414
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30346-1676
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4343 SHALLOWFORD RD STE 540
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-5071
Country	:	US
Telephone Number	:	770-405-1249
Fax Number	:

Authorized Official
Title or Position	:	FAMILY NURSE PRACTITIONER
Name	:	JACKIE BASSONG
Credential	:	FNP-C
Telephone Number	:	678-896-3122

Provider Enumeration Date	:	03/26/2026
Last Update Date	:	03/26/2026

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Directions to “SOLAIRE INTEGRATIVE HEALTH ” Practice Location

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