Boutwell, Justin
Boutwell, Justin is an individual health care provider with primary practice located at 145 Memorial Dr , Broken Bow NE 68822-1378. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Boutwell, Justin can be contacted via phone (308) 872-2486.Contact Information
Primary practice address
145 Memorial Dr
Broken Bow NE 68822-1378
Phone: (308) 872-2486
Fax: (308) 872-2027
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 2387 | Nebraska |
Profile Details
| NPI number | 1861959017 |
|---|---|
| LBN Legal business name | Boutwell, Justin |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 25th, 2019 |
| Last updated | Aug 19th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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