Provider Demographics
NPI:1225311541
Name:SHEA, LETICIA AUDREY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LETICIA
Middle Name:AUDREY
Last Name:SHEA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:LETICIA
Other - Middle Name:AUDREY
Other - Last Name:BUFFET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 REGIS BLVD # H-28
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80221-1099
Mailing Address - Country:US
Mailing Address - Phone:303-847-9928
Mailing Address - Fax:
Practice Address - Street 1:1601 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1216
Practice Address - Country:US
Practice Address - Phone:303-861-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO187831835P2201X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory CareGroup - Single Specialty