Individual provider · Type 1 NPI
Justin Henderson, NP
Nurse Practitioner · Hayden, ID
Practice location
151 W Prairie Ave
Hayden, ID 83835-8284
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 68018 (ID) |
| Family Nurse Practitioner | 363LF0000X | 9132375-4405 (UT) |
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 1770112138
Justin Henderson, NP's National Provider Identifier is 1770112138, issued on Apr 7, 2020. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Hayden, ID. The record was last updated on Feb 22, 2026.