Justin Nielson

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

12312699-4405 Issued in UT

Practice address

910 S 300 W
Blanding, UT 84511-3921

Phone

(435) 678-0700

NPI assigned

Oct 6, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779840000000",
    "number": "1689399271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "845340130",
            "telephone_number": "435-678-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 S 300 W",
            "city": "BLANDING",
            "state": "UT",
            "postal_code": "845113921",
            "telephone_number": "435-678-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "JUSTIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-06",
        "last_updated": "2026-05-27",
        "certification_date": "2026-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "UT",
            "license": "12312699-3102",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "12312699-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mountain West Medical Supply, LLC
• Lita Nakai
• Marita Nakai
• Rita Nakai
• Dana K. Nielson, PHARMACIST
• Norman S Nielson, M.D.
• Nizhoni Dine Transport, Inc.
• Norco Inc.
• Outpost Health, PLLC
• James Ryan Palmer, PHARMD

• All providers in Blanding, UT
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.