IndividualActive
Konnie Luczak, RD, LD
NPI 1114359205 · Registered Dietitian · Woodbury, MN
Provider details
- NPI number
- 1114359205
- Entity type
- Individual
- Primary specialty
- Registered DietitianDietary & Nutritional Service Providers
- Credential
- RD, LD
- Sex
- Female
- Sole proprietor
- No
- License
- 3245 (MN)
Specialties & taxonomies
Dietary & Nutritional Service Providers
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
237 Radio Dr Ste 210
Woodbury, MN 55125-4478
Phone: (612) 871-1145
Fax: (612) 870-5491
Street-level locationGet directions
Mailing address
1900 Centracare Cir
Saint Cloud, MN 56303-5000
Registry dates
- Enumerated
- 2013-07-31
- Last updated
- 2022-04-05
- Certified
- 2022-04-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.