NPI age
12 years
Enumerated 2013-06-06
● Active Type 2 · Organization
Intermountain Functional Medicine, Pllc
Intermountain Functional Medicine, Pllc is 1 of 1280 nurse practitioner organizations in Idaho.
Primary specialty
Nurse Practitioner
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Bowen
Sole Member
Last NPPES update
2013-06-06
Source: monthly bulk 2026-05
How this organization compares
Across 1280 active nurse practitioner providers in Idaho.
NPI age
12 years
↑ 5 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2013 → 2026
2013-06Enumerated in NPPES
2013
2026
Where they practice
Primary practice location
913 S Allante Pl
Boise, ID 837091612
Mailing address
13960 W Wainwright Dr
Boise, ID 837131969
Authorized official
Kathy L Bowen, FNP-C
Sole Member
📞 2089475390
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | NP816A | LICENSE NUMBER |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.