Individual
STACIA S ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Mailing address
1900 CENTRACARE CIR, SAINT CLOUD, MN 56303-5000
(320) 654-3630
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
44297
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
052720300
MEDICAL ASSISTANCE MA
—
01
—
0702359
MEDICA HEALTH PLANS
—
01
—
1030414
PREFERRED ONE
—
01
—
141335
U CARE
—
01
—
1545844
ARAZ GROUP AMERICAS PPO
—
01
—
160056138
RR MEDICARE
—
01
—
1855107
FIRST HEALTH PLAN
—
01
—
55G63AN
BLUE CROSS BLUE SHIELD
—
01
—
C11369
RR MEDICARE
—
01
—
COMP
MMSI
—
01
—
HP34883
HEALTH PARTNERS
—
Enumeration date
11/04/2005
Last updated
11/22/2011
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