| Doctor Name: | MINDY S STAVETEIG |
| NPI Number: | 1154509479 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 10889 |
| Business Practice Address: | 104 N Park St Northwood, ND - 582674103 |
| Business Phone Number: | 7015876000 |
| Business Fax Number: | 7015876009 |
| Mailing Address: | 400 S Minnesota Street, CROOKSTON |
| State: | MN |
| Postal Code: | 56716 |
| Phone Number: | 7015876000 |
| Fax Number: | 7015876009 |
| NPI Enumeration Date: | 02/08/2008 |
| NPI Last Update Date: | 03/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 10889 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |