Healthcare Provider Details

I. General information

NPI: 1154989044
Provider Name (Legal Business Name): HEATHER NICOLE ASHLEY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 BATTLEFIELD BLVD N STE 111
CHESAPEAKE VA
23320-4878
US

IV. Provider business mailing address

241 CORPORATE BLVD STE 210
NORFOLK VA
23502-4965
US

V. Phone/Fax

Practice location:
  • Phone: 757-844-6529
  • Fax: 757-548-9563
Mailing address:
  • Phone: 636-938-2596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0620000053
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: