MEDICARE: KELCY LOY WHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WW0101X	Ambulatory Women's Health Care Registered Nurse	931694	TX
2	363LW0102X	Women's Health Nurse Practitioner	1208581	TX

General Provider Information

NPI Number	:	1053202663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELCY LOY WHNP-BC

Provider Business Mailing Address
First Line	:	140 BRADY CREEK WAY
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-4652
Country	:	US
Telephone Number	:	678-925-8059
Fax Number	:

Provider Business Practice Location Address
First Line	:	2911 MEDICAL ARTS SQUARE
Second Line	:	BUILDINGS 2 AND 3
City	:	AUSTIN
State	:	TX
Zip	:	78705
Country	:	US
Telephone Number	:	512-391-0175
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2025
Last Update Date	:	08/07/2025

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