Individual
JORDAN BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-C
Contact information
Practice address
623 W SANFORD ST, IDAHO FALLS, ID 83402-1318
(208) 204-0539
(208) 643-5975
Mailing address
623 W SANFORD ST, IDAHO FALLS, ID 83402-1318
(208) 204-0539
(208) 643-5975
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5871743
ID
Other
Enumeration date
02/12/2025
Last updated
11/14/2025
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