Individual
LILIYA YANYK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12635 W GAMBRELL ST, STAR, ID 83669-5142
(208) 912-2892
Mailing address
12635 W GAMBRELL ST, STAR, ID 83669-5142
(208) 912-2892
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
7671735
ID
Other
Enumeration date
10/27/2025
Last updated
10/27/2025
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