Individual
ALIX VATH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
250 SCOTT LN STE 105, JACKSON, WY 83001-8060
(985) 630-9499
Mailing address
PO BOX 11603, JACKSON, WY 83002-1603
(985) 630-9499
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
56295
WY
Other
Enumeration date
02/09/2026
Last updated
02/09/2026
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