Provider Demographics
NPI:1285995845
Name:BOLAR, ERICA CHANISE (DNP, FNP-C, APRN)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:CHANISE
Last Name:BOLAR
Suffix:
Gender:F
Credentials:DNP, FNP-C, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4027 CAITLYN PL
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30360-3225
Mailing Address - Country:US
Mailing Address - Phone:404-451-7529
Mailing Address - Fax:404-868-5162
Practice Address - Street 1:6045 ATLANTIC BLVD STE 225
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-1327
Practice Address - Country:US
Practice Address - Phone:678-250-4659
Practice Address - Fax:404-868-5162
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-30
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN191538363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty