Provider Demographics
NPI:1730401878
Name:ADAMS, HEATHER JONES (ARNP)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:JONES
Last Name:ADAMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1031 WELLINGTON WAY STE 245
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40513-1256
Mailing Address - Country:US
Mailing Address - Phone:859-303-8746
Mailing Address - Fax:859-303-8814
Practice Address - Street 1:207 MAIN ST
Practice Address - Street 2:
Practice Address - City:CRAB ORCHARD
Practice Address - State:KY
Practice Address - Zip Code:40419-9697
Practice Address - Country:US
Practice Address - Phone:606-355-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-16
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006368363LF0000X
KY6368P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100141940Medicaid
KYK086400Medicare PIN