Organization
BOLD ARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUFUNKE MUKOMI ADEWUNMI DNP, PMHNP-BC (CEO)
(678) 898-1927
Entity
Organization
Contact information
Practice address
3905 HARRISON RD STE 500, LOGANVILLE, GA 30052-5895
(678) 898-1927
(678) 798-8880
Mailing address
3905 HARRISON RD STE 500, LOGANVILLE, GA 30052-5895
(678) 898-1927
(678) 798-8880
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/06/2025
Last updated
03/27/2026
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