Healthcare Provider Details

I. General information

NPI: 1053202663
Provider Name (Legal Business Name): KELCY LOY WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 MEDICAL ARTS SQUARE BUILDINGS 2 AND 3
AUSTIN TX
78705
US

IV. Provider business mailing address

140 BRADY CREEK WAY
LEANDER TX
78641-4652
US

V. Phone/Fax

Practice location:
  • Phone: 512-391-0175
  • Fax:
Mailing address:
  • Phone: 678-925-8059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number931694
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1208581
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: