Provider Demographics
NPI:1467894782
Name:OLIVER, HEATHER JOLYNN (OD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:JOLYNN
Last Name:OLIVER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:25 STERLING WAY STE C
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-1174
Mailing Address - Country:US
Mailing Address - Phone:859-498-4800
Mailing Address - Fax:859-498-2021
Practice Address - Street 1:25 STERLING WAY STE C
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-1174
Practice Address - Country:US
Practice Address - Phone:859-498-4800
Practice Address - Fax:859-498-2021
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1936DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100261670Medicaid