Individual
KATYLYNN ANN DIZDAREVIC-MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9850 W ST LUKES DR, NAMPA, ID 83687-7912
(208) 463-7300
(208) 463-7301
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M17436
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/09/2022
Last updated
08/06/2025
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