MEDICARE: KATIE GRIFFITH RDN, LD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	4055	MN

General Provider Information

NPI Number	:	1144886722
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIE GRIFFITH RDN, LD

Provider Business Mailing Address
First Line	:	200 1ST ST SW
Second Line	:
City	:	ROCHESTER
State	:	MN
Zip	:	55905-0001
Country	:	US
Telephone Number	:	507-284-2511
Fax Number	:

Provider Business Practice Location Address
First Line	:	6872 TAPESTRY SPRINGS SQ APT 111
Second Line	:
City	:	APOLLO BEACH
State	:	FL
Zip	:	33572-1686
Country	:	US
Telephone Number	:	507-766-6275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2019
Last Update Date	:	03/29/2025

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