Henderson, Justin

Henderson, Justin is an individual health care provider with primary practice located at 30544 Id-200 #101, Ponderay ID 83852. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Henderson, Justin can be contacted via phone (208) 263-6300.

Contact Information

Primary practice address
30544 Id-200 #101 Ponderay ID 83852
Phone: (208) 263-6300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 9132375-4405 Utah

Profile Details

NPI number 1770112138
LBN Legal business name Henderson, Justin
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 7th, 2020
Last updated Apr 6th, 2024 - about last year

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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