Healthcare Provider Details

I. General information

NPI: 1275250102
Provider Name (Legal Business Name): TROY LINNEMEYER CARR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 E COMMERCE ST
NAMPA ID
83687-5513
US

IV. Provider business mailing address

6259 W EMERALD ST
BOISE ID
83704-8731
US

V. Phone/Fax

Practice location:
  • Phone: 208-489-1900
  • Fax:
Mailing address:
  • Phone: 208-489-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number61445
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61445
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: