Provider Demographics
NPI:1336143924
Name:ARBON, JANEL (RD)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:
Last Name:ARBON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 JUAN CT
Mailing Address - Street 2:
Mailing Address - City:MOAB
Mailing Address - State:UT
Mailing Address - Zip Code:84532-2125
Mailing Address - Country:US
Mailing Address - Phone:435-651-3291
Mailing Address - Fax:435-651-3376
Practice Address - Street 1:454 JUAN CT
Practice Address - Street 2:
Practice Address - City:MOAB
Practice Address - State:UT
Practice Address - Zip Code:84532-2125
Practice Address - Country:US
Practice Address - Phone:435-259-1638
Practice Address - Fax:435-651-3376
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT313051-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTP64185Medicare UPIN