Provider Demographics
NPI:1508670605
Name:EICH, LAUREN ROCHELLE (MS, RD, LD, CLC)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ROCHELLE
Last Name:EICH
Suffix:
Gender:F
Credentials:MS, RD, LD, CLC
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ROCHELLE
Other - Last Name:PATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RD, LD, CLC
Mailing Address - Street 1:738 RIESGRAF RD
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MN
Mailing Address - Zip Code:55315-4522
Mailing Address - Country:US
Mailing Address - Phone:763-244-6619
Mailing Address - Fax:
Practice Address - Street 1:738 RIESGRAF RD
Practice Address - Street 2:
Practice Address - City:CARVER
Practice Address - State:MN
Practice Address - Zip Code:55315-4522
Practice Address - Country:US
Practice Address - Phone:763-244-6619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4139133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered