JUSTIN BOUTWELL, PA, Medical BROKEN BOW, NE

Contact Information

JUSTIN BOUTWELL, PA

145 MEMORIAL DR
BROKEN BOW, NE 68822-1378

Phone: 308-872-2486
Fax: 308-872-2027
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Medical	363AM0700X	97	Physician Assistant

Indicates primary specialty

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NPI Profile & details for JUSTIN BOUTWELL · (Male)

NPI Number	`1861959017`
Status	Active
Credentials	PA (Physician Assistant)
Entity	Individual
Enumeration date	02/25/2019
Last updated	08/19/2019 - About 7 years ago
Sole proprietor ¹	No
Identifiers	NE License # 2387
Hospital affiliation(s)	JENNIE M MELHAM MEMORIAL MEDICAL CENTER - (Critical Access) 145 MEMORIAL DRIVE BROKEN BOW, NE 68822

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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JUSTIN BOUTWELL, PA – NPI #1861959017Medical

Contact Information

Specialty

Medical

NPI Profile & details for JUSTIN BOUTWELL · (Male)

Reviews for JUSTIN BOUTWELL

JUSTIN BOUTWELL, PA – NPI #1861959017
Medical