Organization · Type 2 NPI
Bold Ark LLC
Psychiatric/Mental Health Nurse Practitioner · Loganville, GA
NPI number
1740079623
Active
Practice location
3905 Harrison Rd Ste 500
Loganville, GA 30052-5895
Fax (678) 798-8880
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | None listed |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1740079623
Bold Ark LLC's National Provider Identifier is 1740079623, issued on May 6, 2025. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Loganville, GA. The record was last updated on Mar 27, 2026.