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General NPI Number Information
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NPI Number | 1790505519
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Entity Type | Individual
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Provider Name | STEVI MEADE PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/15/2024
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 320 E 2ND ST
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City | LIBBY
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State | MT
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Zip | 59923-2010
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Country | US
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Telephone | 406-283-6900
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Fax |
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Provider Business Mailing Address
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Address Line | 2048 AIRPORT RD APT 104
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City | KALISPELL
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State | MT
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Zip | 59901-5861
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Country | US
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Telephone | 406-207-3659
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | MED-PAC-LIC-145755
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License Number State | MT
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