Individual
DR. SHEALEEN A PANETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
580 MOHAWK DR, BOULDER, CO 80303-3712
(303) 338-4545
Mailing address
2500 S HAVANA ST, AURORA, CO 80014-1618
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2936
CO
152W00000X
Optometrist
OP1000097
DC
152W00000X
Optometrist
TA1960
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024871
KAISER COMMERCIAL NUMBER
CO
05
—
64778223
—
CO
Enumeration date
11/28/2006
Last updated
05/04/2021
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