IndividualActive
Alexis Vantiem, PA-C
NPI 1124706627 · Physician Assistant · Superior, MT
Provider details
- NPI number
- 1124706627
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- MED-PAC-LIC-145618 (MT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Student, Health Care
Practice location
1208 6th Ave. E
Superior, MT 59872
Phone: (406) 822-4803
Fax: (406) 822-3848
Approximate (ZIP-level) locationGet directions
Mailing address
P.o. Box 66
Superior, MT 59872
Registry dates
- Enumerated
- 2023-07-06
- Last updated
- 2025-12-01
- Certified
- 2025-12-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.