Individual
JESSICA LYNN STAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1300 ANNE ST NW, BEMIDJI, MN 56601-5103
(218) 333-5000
(218) 333-5360
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(218) 333-5000
(218) 333-5360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
62728
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/01/2016
Last updated
04/29/2022
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