MEDICARE: DR. KERRI DIANNE TRAINER DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	0286	ID

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	050090361	OTHER	ID	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1477537280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KERRI DIANNE TRAINER DO

Provider Business Mailing Address
First Line	:	PO BOX 7411114
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60674-1114
Country	:	US
Telephone Number	:	208-367-5170
Fax Number	:	208-367-5180

Provider Business Practice Location Address
First Line	:	1055 N CURTIS RD
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83706-1309
Country	:	US
Telephone Number	:	208-367-5170
Fax Number	:	208-367-5180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	10/02/2023

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