Provider Demographics
NPI:1528821188
Name:RYBIN, JACLYN (RDN)
Entity type:Individual
Prefix:MS
First Name:JACLYN
Middle Name:
Last Name:RYBIN
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 W THOMAS RD APT 26
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015-6168
Mailing Address - Country:US
Mailing Address - Phone:623-565-0247
Mailing Address - Fax:
Practice Address - Street 1:1840 W THOMAS RD APT 26
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-6168
Practice Address - Country:US
Practice Address - Phone:623-565-0247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered