Provider Demographics
NPI:1073982914
Name:EPERSON, HEATHER DAWN (APRN)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:DAWN
Last Name:EPERSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 628
Mailing Address - Street 2:
Mailing Address - City:PAINTSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41240-0628
Mailing Address - Country:US
Mailing Address - Phone:606-788-0303
Mailing Address - Fax:606-788-0310
Practice Address - Street 1:604 JAMES S TRIMBLE BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:PAINTSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41240
Practice Address - Country:US
Practice Address - Phone:606-788-0303
Practice Address - Fax:606-788-0310
Is Sole Proprietor?:No
Enumeration Date:2015-09-22
Last Update Date:2017-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3009728363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily