Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JUSTIN BOUTWELL, PA
ActiveMR. JUSTIN BOUTWELL, PA is a Medical Physician Assistant healthcare provider located in BROKEN BOW, Nebraska. NPI 1861959017 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · BROKEN BOW, NE
Registration Details
- NPI Number
- 1861959017
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 25, 2019 (7.4235312051951 yrs)
- Last Updated
- Aug 19, 2019
- License
-
2387 (NE)
Practice Information
- Address
-
145 MEMORIAL DRBROKEN BOW, NE, 688221378Browse NE providers · Browse ZIP 68822
- Phone
- 3088722486
- Fax
- 3088722027
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.