INTERMOUNTAIN FUNCTIONAL MEDICINE, PLLC
NPI 1659719177
Nurse Practitioner - Family in Boise, ID

Q: What is Intermountain Functional Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since June 06, 2013

913 S ALLANTE PL, BOISE, ID 83709(208) 947-5390(208) 947-3465 Get Directions Write a Review

NPPES record last updated: June 6, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Intermountain Functional Medicine, Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERMOUNTAIN FUNCTIONAL MEDICINE, PLLC (NPI 1659719177) is a healthcare organization registered as a family in Boise, Idaho and active in the NPI registry since June 2013. The organization lists Kathy L Bowen, Sole Member, as its authorized official.

NPPES Registry Identity

NPI1659719177

Entity TypeOrganization

Primary Taxonomy363LF0000X

Legal Business NameINTERMOUNTAIN FUNCTIONAL MEDICINE, PLLC

Location Address913 S ALLANTE PLBoise, ID 83709-1612

Mailing Address13960 W Wainwright DrBoise, ID 83713-1969 · (208) 947-5390 · Fax (208) 947-3465

Phone(208) 947-5390

Fax(208) 947-3465

Organization SubpartNo

Authorized OfficialKathy L BowenSole Member · (208) 947-5390

Enumeration DateJune 6, 2013

✔ NPI 1659719177 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in ID · NP816A

913 S ALLANTE PL, Boise, ID 83709

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Other Identifiers 1

OtherNP816AID · License Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Intermountain Functional Medicine, PLLC's NPI number?

The NPI number for Intermountain Functional Medicine, PLLC is 1659719177. It was assigned to this organization in the NPPES registry on June 6, 2013.

Where is Intermountain Functional Medicine, PLLC located?

Intermountain Functional Medicine, PLLC is located at 913 S Allante Pl, Boise, ID 83709. The listed phone number is (208) 947-5390.

What is Intermountain Functional Medicine, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Intermountain Functional Medicine, PLLC was last updated on June 6, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.