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NPI Code Detail

MEDICARE: SUSAN E LOFGREN RD

MEDICARE: SUSAN E LOFGREN 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
1133V00000XRegistered Dietitian1887MN

General Provider Information

NPI Number : 1902744675
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN E LOFGREN RD
Provider Business Mailing Address
First Line : 1650 4TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-4717
Country : US
Telephone Number : 507-529-6600
Fax Number :
Provider Business Practice Location Address
First Line : 1650 4TH ST SE
Second Line :
City : ROCHESTER
State : MN
Zip : 55904-4717
Country : US
Telephone Number : 507-529-6600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2026
Last Update Date : 03/24/2026

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Directions to “ SUSAN E LOFGREN RD” Practice Location

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