Healthcare Provider Details

I. General information

NPI: 1568277598
Provider Name (Legal Business Name): BRITNEY J BOCHENEK PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2025
Last Update Date: 07/24/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

393 E 2ND N
REXBURG ID
83440-1605
US

IV. Provider business mailing address

1653 W 7800 S
REXBURG ID
83440-4521
US

V. Phone/Fax

Practice location:
  • Phone: 208-359-4840
  • Fax: 208-359-9010
Mailing address:
  • Phone: 208-390-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5171850
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: