Provider Demographics
NPI:1588856058
Name:KESSLER, SHANNON SCHAEFER (OD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:SCHAEFER
Last Name:KESSLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MISS
Other - First Name:SHANNON
Other - Middle Name:NICOLE
Other - Last Name:SCHAEFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14400 E JEWELL AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-5689
Mailing Address - Country:US
Mailing Address - Phone:303-270-6407
Mailing Address - Fax:303-751-0171
Practice Address - Street 1:14400 E JEWELL AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-5689
Practice Address - Country:US
Practice Address - Phone:303-270-6407
Practice Address - Fax:303-751-0171
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2651152W00000X, 152WL0500X
OR3229ATI152W00000X
WAOD 60031965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152W00000XEye and Vision Services ProvidersOptometrist