Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Justin Henderson, NP

Individual provider Nurse Practitioner · NPI 1770112138

Justin Henderson, NP is a Nurse Practitioner in Hayden, Idaho. Qualified in 2019, 7 years ago. Practices with Indigo Idaho Services, LLC, a 10-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Utah.

Years since qualifying
7
Licensed in
ID, UT
In the registry since
2020
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

151 W Prairie Ave
Hayden, ID 83835-8284
Phone: (208) 719-4880
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 68018 (ID)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 9132375-4405 (UT)

Record details

NPI number1770112138
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 7, 2020
Last updated in NPPESFebruary 22, 2026
Certification dateFebruary 22, 2026
Mailing address151 W Prairie Ave, Hayden, ID 83835-8284

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Indigo Idaho Services, Llc — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

Other providers in Hayden