Provider Demographics
NPI:1528375672
Name:BURCHETT, HEATHER TETER (ARNP)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:TETER
Last Name:BURCHETT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:LEIGH
Other - Last Name:TETER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5200 COMMERCE CROSSINGS DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40229-2182
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:107 MERIDIAN WAY STE 200
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2878
Practice Address - Country:US
Practice Address - Phone:859-624-6366
Practice Address - Fax:859-971-4695
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6631P363LP0808X
KY3006631363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health