Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Intermountain Functional Medicine, PLLC

Organization Family Nurse Practitioner · NPI 1659719177

Intermountain Functional Medicine, PLLC provides Family Nurse Practitioner services in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2013.

Licensed in
ID
In the registry since
2013
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

913 S Allante Pl
Boise, ID 83709-1612 Not confirmed with CMS for 13 years — call before visiting
Phone: (208) 947-5390
Fax: (208) 947-3465
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP816A (ID)

Record details

NPI number1659719177
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kathy Bowen — Sole Member · (208) 947-5390
NPI enumeratedJune 6, 2013
Last updated in NPPESJune 6, 2013
Mailing address13960 W Wainwright Dr, Boise, ID 83713-1969

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