MEDICARE: JANE ELIZABETH PFEUFER RD

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	D12203	ME

General Provider Information

NPI Number	:	1417808890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANE ELIZABETH PFEUFER RD

Provider Business Mailing Address
First Line	:	74 UNION ST APT 3
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-2432
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	74 UNION ST APT 3
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-2432
Country	:	US
Telephone Number	:	404-775-6149
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ JANE ELIZABETH PFEUFER RD” Practice Location

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