MS. Loranda Lee Banker MS,RD,LDN

Overview of MS. Loranda Lee Banker MS,RD,LDN

• NPI number: 1063059160
• Provider type: Individual
• Specialty: Dietitian, Registered
• Gender: Female
• Active since: 09/30/2013
• Last updated: 09/30/2013

Primary Scrop of Practice

• Taxonomy Code: 133V00000X
• Specialty: Dietitian, Registered
• License Number: 164.003241
• License State: IL

Provider Mailing Address

• Address: 623 N Main St
  Flora, IL 62839
• Phone: 618-676-5748
• Fax:

Provider Practice Location

• Address: 623 N Main St
  Flora, IL 62839
• Phone: 618-676-5748
• Fax:

Scope of Practice

• Taxonomy Code: 133V00000X
• Specialty: Dietitian, Registered
• License Number: 164.003241
• License State: IL
• Switch: Yes

Legacy Identifiers

• Provider Identifier: K23388
• Identifier Type: Other
• Identifier State: IL
• Issuer: MEDICARE PART B PROVIDER