Provider Demographics
NPI:1659969020
Name:DE LANCEY, KRISTYN RUTH
Entity Type:Individual
Prefix:
First Name:KRISTYN
Middle Name:RUTH
Last Name:DE LANCEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 E MARTIN LUTHER KING JR BLVD # 1
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-1617
Mailing Address - Country:US
Mailing Address - Phone:512-801-7240
Mailing Address - Fax:
Practice Address - Street 1:3011 E MARTIN LUTHER KING JR BLVD # 1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-1617
Practice Address - Country:US
Practice Address - Phone:512-801-7240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-01
Last Update Date:2021-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula