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

Mr. Justin Boutwell, PA

Individual provider Medical Physician Assistant · NPI 1861959017

Mr. Justin Boutwell, PA is a Medical Physician Assistant in Broken Bow, Nebraska. Works from 2 locations. Licensed in Nebraska.

Licensed in
NE
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

145 Memorial Dr
Broken Bow, NE 68822-1378
Phone: (308) 872-2486
Fax: (308) 872-2027
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1316 Logan St, Holdrege, NE 68949-1448 — (308) 991-4571

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2387 (NE)

Record details

NPI number1861959017
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 25, 2019
Last updated in NPPESAugust 19, 2019

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