Healthcare Provider Details

I. General information

NPI: 1225311541
Provider Name (Legal Business Name): LETICIA AUDREY SHEA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DR. LETICIA AUDREY BUFFET

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 08/30/2023
Certification Date: 08/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE
DENVER CO
80218-1216
US

IV. Provider business mailing address

3333 REGIS BLVD # H-28
DENVER CO
80221-1099
US

V. Phone/Fax

Practice location:
  • Phone: 303-861-7001
  • Fax:
Mailing address:
  • Phone: 303-847-9928
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number18783
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number18783
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: