NPI age
3 years
Enumerated 2022-06-08
● Active
Type 1 · Individual
MacKenzie Gustafson, PMHNP
Gustafson is 1 of 18 nurse practitioner providers in Twin Falls and 1 of 374 in Idaho.
Primary specialty
Nurse Practitioner
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2022-08-19
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 374 active nurse practitioner providers in Idaho.
NPI age
3 years
≈ at median (4 yr)
State licenses
1 state
13% of peers hold multiple states
Subspecialties
0
34% of peers hold subspecialties
NPI lifetime · 2022 → 2026
2022-06Enumerated in NPPES
2022
2026
Where they practice
Practice location
414 Shoup Ave W Ste B
Twin Falls, ID 833015042
Mailing address
190 E Bannock St
Boise, ID 837126241
Specialties
-
Nurse Practitioner PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.