Provider Demographics
NPI:1811069370
Name:KARNEY, JERRILEA (DC)
Entity type:Individual
Prefix:
First Name:JERRILEA
Middle Name:
Last Name:KARNEY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:LA JUNTA
Mailing Address - State:CO
Mailing Address - Zip Code:81050-2902
Mailing Address - Country:US
Mailing Address - Phone:719-384-8039
Mailing Address - Fax:719-384-2621
Practice Address - Street 1:12 E 10TH ST
Practice Address - Street 2:
Practice Address - City:LA JUNTA
Practice Address - State:CO
Practice Address - Zip Code:81050-2902
Practice Address - Country:US
Practice Address - Phone:719-384-8039
Practice Address - Fax:719-384-2621
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO350013415Medicare PIN
COT60676Medicare UPIN
COC22963Medicare PIN