Provider Demographics
NPI:1811679269
Name:INTEGRATED HEALTH AND WELLNESS SOLUTIONS
Entity type:Organization
Organization Name:INTEGRATED HEALTH AND WELLNESS SOLUTIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELVA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, APRN, FNP-C
Authorized Official - Phone:470-666-4762
Mailing Address - Street 1:1333 CEDAR GROVE RD UNIT 1136
Mailing Address - Street 2:
Mailing Address - City:CONLEY
Mailing Address - State:GA
Mailing Address - Zip Code:30288-2542
Mailing Address - Country:US
Mailing Address - Phone:470-666-4762
Mailing Address - Fax:
Practice Address - Street 1:4146 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:FOREST PARK
Practice Address - State:GA
Practice Address - Zip Code:30297-1038
Practice Address - Country:US
Practice Address - Phone:678-799-1218
Practice Address - Fax:770-264-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty