Healthcare Provider Details

I. General information

NPI: 1467894782
Provider Name (Legal Business Name): HEATHER JOLYNN OLIVER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 STERLING WAY STE C
MT STERLING KY
40353-1174
US

IV. Provider business mailing address

25 STERLING WAY STE C
MT STERLING KY
40353-1174
US

V. Phone/Fax

Practice location:
  • Phone: 859-498-4800
  • Fax: 859-498-2021
Mailing address:
  • Phone: 859-498-4800
  • Fax: 859-498-2021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1936DT
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: