Shelly M. Leitch, RN, MSN, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

453991 Issued in TX

Practice address

416 Highway 87
Teen Health Center, Inc.-Crenshaw
Crystal Beach, TX 77650

Phone

(409) 766-5750

NPI assigned

Jan 3, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Master of Science - Nursing, Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346307634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SEACREST BLVD",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775739231",
            "telephone_number": "281-538-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 HIGHWAY 87",
            "address_2": "TEEN HEALTH CENTER, INC.-CRENSHAW",
            "city": "CRYSTAL BEACH",
            "state": "TX",
            "postal_code": "77650",
            "telephone_number": "409-766-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITCH",
        "first_name": "SHELLY",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "RN, MSN, CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "453991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cindy Y Cavazos
• Crystal Beach Medical Clinic LLC
• Crystal Beach Volunteer Fire
• Galveston County Emergency Services District -2
• J & J Pharmacy
• Michael F Rodgers, LVN
• St. Christopher Medical Clinic, Inc.

• Pediatric Nurse Practitioner in Crystal Beach, TX
• Providers in Crystal Beach, TX by specialty
• Pediatric Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.