Provider Demographics
NPI:1174981922
Name:SHOVAL, LEAH PL (MSN, CPNP-PC, IBCLC)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:PL
Last Name:SHOVAL
Suffix:
Gender:F
Credentials:MSN, CPNP-PC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5523 13TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-3501
Mailing Address - Country:US
Mailing Address - Phone:310-779-7466
Mailing Address - Fax:
Practice Address - Street 1:8630 FENTON ST STE 1200
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3808
Practice Address - Country:US
Practice Address - Phone:015-851-2503
Practice Address - Fax:301-585-6289
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1030144163W00000X
DCL-88331163WL0100X
DCNP1030144363LP0200X
MDR244915363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant