Kristie M Lavalley, L.AC.
Individual provider Active NPI Acupuncturist · Cedaredge, CO
NPI 1760637508 · NPPES record last updated Nov 20, 2008
Key facts
- NPI
- 1760637508
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- 1293 (CO)
- Practice address
- 190 N Grand Mesa Dr
Cedaredge, CO 81413-8388 - Phone
- (970) 856-4729
- Fax
- (970) 856-4734
- NPI assigned
- Nov 20, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1293 | CO | MD | Acupuncturist |
| AC00882 | TX | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Millennium Wellness, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 1293 | CO | Yes |
| Acupuncturist | 171100000X | AC00882 | TX |
Addresses
Primary practice location
190 N Grand Mesa Dr
Cedaredge, CO 81413-8388
Mailing address
190 N Grand Mesa Dr
Cedaredge, CO 81413-8388
Phone (970) 856-4729
Other providers in Cedaredge, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.