Healthcare Provider Details

I. General information

NPI: 1548124134
Provider Name (Legal Business Name): RACHEL BOWMAN PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 S ROOKERY LN
BOISE ID
83706-5484
US

IV. Provider business mailing address

2650 W CHARLOTTE DR
IDAHO FALLS ID
83402-5613
US

V. Phone/Fax

Practice location:
  • Phone: 208-428-1588
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408265
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2871095
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: