Provider Demographics
NPI:1215254024
Name:LYUBOSLAVSKY, YULIA A (APN, ACNS-BC)
Entity type:Individual
Prefix:MRS
First Name:YULIA
Middle Name:A
Last Name:LYUBOSLAVSKY
Suffix:
Gender:F
Credentials:APN, ACNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4310 JAMES CASEY ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1251
Mailing Address - Country:US
Mailing Address - Phone:512-448-4588
Mailing Address - Fax:
Practice Address - Street 1:4310 JAMES CASEY ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1251
Practice Address - Country:US
Practice Address - Phone:512-448-4588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX728708364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health