MINDY S STAVETEIG (NPI# 1154509479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154509479 |
| Entity Type | Individual |
| Full Name | MINDY S STAVETEIG |
| Other Name | MINDY ANDERSON |
| Credential | PA-C |
| Practice Address |
400 S Minnesota St Crookston MN 56716-1808 |
| Mailing Address |
400 S Minnesota Street Crookston MN 56716 |
| Practice Telephone | 2182819100 |
| Practice Fax Number | 2182819189 |
| Mailing Telephone | 7015876000 |
| Mailing Fax Number | 7015876009 |
| Enumeration Date | 2008-02-08 |
| Last Update Date | 2018-08-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10889 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 342440000 | 05 | |
| PREFERRED ONE | NA9481054162 | 01 | |
| MN | MN BCBS | 03M31AN | 01 |
| ND | ND BCBS | 30806 | 01 |
| TRICARE | 30806 | 01 | |
| MEDICA | 1154509479 | 01 |
| Street Address |
400 S MINNESOTA ST |
| City | CROOKSTON |
| State | MN |
| Zip Code | 56716-1808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538105929 | Altru Specialty Services, Inc. | Durable Medical Equipment & Medical Supplies | 400 S Minnesota St, Crookston, MN 56716-1808 | 2006-06-22 |
| 1669014643 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 400 S Minnesota St, Crookston, MN 56716-1808 | 2019-10-11 |
| 1578041653 | Breanna J. Privratsky | Physician Assistant | 400 S Minnesota St, Crookston, MN 56716-1808 | 2018-08-01 |
| 1558746081 | Emily Ann Andrews | Physician Assistant | 400 S Minnesota St, Crookston, MN 56716-1808 | 2015-07-27 |
| 1629327010 | Mary Lee Beck | Clinical Nurse Specialist | 400 S Minnesota St, Crookston, MN 56716-1808 | 2012-08-31 |
| 1629347489 | Altru Health System | Clinic/Center | 400 S Minnesota St, Crookston, MN 56716-1808 | 2011-12-23 |
| 1184936072 | Roshan Ghimire | Family Medicine | 400 S Minnesota St, Crookston, MN 56716-1808 | 2010-07-08 |
| 1841338514 | Altru Specialty Services, Inc. | Durable Medical Equipment & Medical Supplies | 400 S Minnesota St, Crookston, MN 56716-1808 | 2007-02-02 |
| 1376638627 | Donna A Anel | Internal Medicine | 400 S Minnesota St, Crookston, MN 56716-1808 | 2006-10-04 |
| 1437242476 | Theodore S Olson | Internal Medicine | 400 S Minnesota St, Crookston, MN 56716-1808 | 2006-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942789912 | Savannah Danielle Miller | Pharmacist | 323 S Minnesota Street, Crookston, MN 56716 | 2018-08-10 |
| 1902037377 | David Fernando Frugone Larrea | Internal Medicine | 400 South Minnesota Street, Crookston, MN 56716 | 2009-08-04 |
| 1831327964 | Andres O Makarem | Internal Medicine | 400 S. Minnesota Ave, Crookston, MN 56716 | 2009-06-26 |
| 1255498564 | Ind School District 593 | Local Education Agency (LEA) | 402 Fisher Ave, Crookston, MN 56716 | 2007-01-03 |
| 1821109422 | Marla Rae Love | Dietitian, Registered | 400 S Minnesota Street, Crookston, MN 56716 | 2006-08-31 |
| 1508835133 | Northwestern Mental Health Center | Clinic/Center | 603 Bruce St, Crookston, MN 56716 | 2006-03-16 |
| 1215932728 | Villa St. Vincent | Skilled Nursing Facility | 516 Walsh St, Crookston, MN 56716 | 2005-06-21 |
| 1740769090 | Christine Jane Loff | Physical Therapist | 323 S Minnesota St, Crookston, MN 56716 | 2018-08-08 |
| 1821533035 | Lauren Shalane Wagendorf | Counselor | 603 Bruce St, Crookston, MN 56716 | 2016-12-23 |
| 1336594449 | Lesmeister Dental LLC | Dentist | 1726 University Ave, Crookston, MN 56716 | 2016-04-26 |
| Find all providers in zip 56716 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598946568 | Ioan John Chitu I | Physician Assistant | 323 S Minnesota St, Crookston, MN 56716-1601 | 2007-11-19 |
| 1417033507 | Karen J Lesetmoe | Physician Assistant | 323 S Minnesota St, Crookston, MN 56716-1601 | 2006-10-31 |
| 1144269374 | Paul L Reese | Physician Assistant | 323 S Minnesota St, Crookston, MN 56716-1601 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969150 | Isaac Waalen | Physician Assistant | 5420 Circle Down, Minneapolis, MN 55416-1312 | 2020-03-28 |
| 1730643701 | Christina Jones | Physician Assistant | 11850 Blackfoot St Nw Ste 270, Coon Rapids, MN 55433-2593 | 2019-01-24 |
| 1114492964 | Molly Goss | Physician Assistant | 1817 Sunset Dr, Northfield, MN 55057-3246 | 2018-10-09 |
| 1932600160 | Ellen Kathryn Freeman | Physician Assistant | 111 Hundertmark Rd Ste 480, Chaska, MN 55318-1485 | 2018-02-22 |
| 1174041875 | Kristen Webb | Physician Assistant | 3931 Louisiana Ave S, Suite E-500, St. Louis Park, MN 55426 | 2017-09-01 |
| 1073051751 | Hannah Elizabeth Rosenthal Danielson | Physician Assistant | 640 Jackson St # Ms 11102m, Saint Paul, MN 55101 | 2017-02-02 |
| 1457893984 | Daniel Ryan Nguyen | Physician Assistant | 14551 Co Rd #11 #100, Burnsville, MN 55337 | 2016-11-15 |
| 1538545686 | Kathryn Jelle | Physician Assistant | 3931 Louisiana Ave S # 55426, St Louis Park, MN 55426-5000 | 2015-07-30 |
| 1831503267 | Karrah Oliver | Physician Assistant | 205 Roosevelt Ave W, Karlstad, MN 56732-4022 | 2014-06-13 |
| 1477981777 | Melissa Ferraz De Toledo | Physician Assistant | 9145 Springbrook Dr Nw Ste 300, Coon Rapids, MN 55433-5897 | 2013-10-23 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.