Healthcare Provider Details

I. General information

NPI: 1326345661
Provider Name (Legal Business Name): ALLANTE FAMILY MEDICINE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2011
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 S RACKHAM WAY
MERIDIAN ID
83642-8816
US

IV. Provider business mailing address

1256 S RACKHAM WAY
MERIDIAN ID
83642-8816
US

V. Phone/Fax

Practice location:
  • Phone: 208-377-5433
  • Fax: 208-629-8179
Mailing address:
  • Phone: 208-377-5433
  • Fax: 208-629-8179

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-980-A
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-927
License Number StateID

VIII. Authorized Official

Name: CARRIE ELLEN VALLE
Title or Position: NURSE PRACTITIONER
Credential: FNP-C
Phone: 208-377-5433