Healthcare Provider Details

I. General information

NPI: 1255813341
Provider Name (Legal Business Name): RAINER LINNEMEYER FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 04/11/2025
Certification Date: 04/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 GODDING HOLLOW PKWY
FREDERICK CO
80504-5432
US

IV. Provider business mailing address

5906 GODDING HOLLOW PKWY
FREDERICK CO
80504-5432
US

V. Phone/Fax

Practice location:
  • Phone: 303-709-5675
  • Fax:
Mailing address:
  • Phone: 303-709-5675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0994133-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: