Individual
MICHELLE M STATELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
705 5TH ST NW STE 2A, BEMIDJI, MN 56601-2932
(218) 444-2718
Mailing address
15855 MAIN AVE, RED LAKE, MN 56671
(218) 444-2718
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/08/2026
Last updated
07/08/2026
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