Provider Demographics
NPI:1689033300
Name:LANGDON, KELLY YAWN (MPH, IBCLC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:YAWN
Last Name:LANGDON
Suffix:
Gender:F
Credentials:MPH, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3608 APACHE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78739-4436
Mailing Address - Country:US
Mailing Address - Phone:512-284-8800
Mailing Address - Fax:
Practice Address - Street 1:7301 BURNET RD STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-2250
Practice Address - Country:US
Practice Address - Phone:512-326-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN