Healthcare Provider Details

I. General information

NPI: 1063076388
Provider Name (Legal Business Name): HEATHER JASMINE HOLTON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER JASMINE BARKER

II. Dates (important events)

Enumeration Date: 04/23/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 23RD ST STE 510
ASHLAND KY
41101-2878
US

IV. Provider business mailing address

PO BOX 4190
BARBOURSVILLE WV
25504-4190
US

V. Phone/Fax

Practice location:
  • Phone: 606-329-9335
  • Fax: 606-324-6383
Mailing address:
  • Phone: 304-399-4405
  • Fax: 304-399-2526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number102705
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number4047875
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: