Healthcare Provider Details

I. General information

NPI: 1649120643
Provider Name (Legal Business Name): KERRI QUINLAN L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2026
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 W 5TH ST
LEADVILLE CO
80461-3510
US

IV. Provider business mailing address

135 CHESTNUT ST
LEADVILLE CO
80461-3635
US

V. Phone/Fax

Practice location:
  • Phone: 719-223-9935
  • Fax:
Mailing address:
  • Phone: 719-223-9935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU.0002832
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: