Individual provider · Type 1 NPI

Amanda Bowen

Nurse Practitioner · Burley, ID

NPI number 1104754688 Active

Practice location

1408 Pomerelle Ave Ste H
Burley, ID 83318-2068

Call (208) 677-6170 Map

Mailing address

PO Box 30180
Salt Lake City, UT 84130-0180

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X59123 (ID)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1104754688

Amanda Bowen's National Provider Identifier is 1104754688, issued on May 13, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Burley, ID. The record was last updated on Sep 28, 2026.