Healthcare Provider Details

I. General information

NPI: 1235067968
Provider Name (Legal Business Name): HALLIE LOBEJKO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 FULTON ST SE
MINNEAPOLIS MN
55455-4800
US

IV. Provider business mailing address

909 FULTON ST SE
MINNEAPOLIS MN
55455-4800
US

V. Phone/Fax

Practice location:
  • Phone: 612-626-5775
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberCFDE-155
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: