Healthcare Provider Details

I. General information

NPI: 1285995845
Provider Name (Legal Business Name): ERICA CHANISE BOLAR DNP, FNP, CARN-AP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6045 ATLANTIC BLVD STE 225
NORCROSS GA
30071-1327
US

IV. Provider business mailing address

1954 AIRPORT RD STE 670
ATLANTA GA
30341-4956
US

V. Phone/Fax

Practice location:
  • Phone: 678-250-4659
  • Fax: 404-868-5162
Mailing address:
  • Phone: 678-250-4659
  • Fax: 404-868-5162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN191538
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberRN191538
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: