MEDICARE: MS. LOENA BYNUM RODGERS CN

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	133NN1002X	Nutrition Education Nutritionist
2	174H00000X	Health Educator
3	133N00000X	Nutritionist	NUTR.NU.61687880	WA

General Provider Information

NPI Number	:	1891636486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LOENA BYNUM RODGERS CN

Provider Business Mailing Address
First Line	:	15728 LORAIN AVE UNIT 398
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15728 LORAIN AVE UNIT 398
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-5542
Country	:	US
Telephone Number	:	818-860-2156
Fax Number	:

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

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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