Healthcare Provider Details

I. General information

NPI: 1154180784
Provider Name (Legal Business Name): CHRISTINA M BOWMAN APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2024
Last Update Date: 12/14/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 MAIN ST STE 106
LEWISTON ID
83501-1819
US

IV. Provider business mailing address

301 MAIN ST STE 106
LEWISTON ID
83501-1819
US

V. Phone/Fax

Practice location:
  • Phone: 208-718-5582
  • Fax: 208-281-3821
Mailing address:
  • Phone: 208-718-5582
  • Fax: 208-281-3821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number7261774
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: