Provider Demographics
NPI:1871974204
Name:ATCHERSON, HEATHER NICHOLE (OD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:NICHOLE
Last Name:ATCHERSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9031 VALLEY CREST LN
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-7829
Mailing Address - Country:US
Mailing Address - Phone:901-757-2020
Mailing Address - Fax:901-751-2399
Practice Address - Street 1:9031 VALLEY CREST LN
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-7829
Practice Address - Country:US
Practice Address - Phone:901-757-2020
Practice Address - Fax:901-751-2399
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN3230152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist