MEDICARE: RACHEL BOWMAN PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	408265	NY
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2871095	ID

General Provider Information

NPI Number	:	1548124134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL BOWMAN PMHNP

Provider Business Mailing Address
First Line	:	2650 W CHARLOTTE DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-5613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2650 W CHARLOTTE DR
Second Line	:
City	:	IDAHO FALLS
State	:	ID
Zip	:	83402-5613
Country	:	US
Telephone Number	:	208-339-8452
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	03/23/2026

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