Healthcare Provider Details

I. General information

NPI: 1851554919
Provider Name (Legal Business Name): KELLY KAEDING M.S., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 NORTH ST
BURLINGTON VT
05401-4246
US

IV. Provider business mailing address

161 NORTH ST
BURLINGTON VT
05401-4246
US

V. Phone/Fax

Practice location:
  • Phone: 802-951-8815
  • Fax:
Mailing address:
  • Phone: 802-951-8815
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number091-0000088
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: