Provider Demographics
NPI:1184309452
Name:TRYBUS, JENNA (RDN/LDN)
Entity type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:TRYBUS
Suffix:
Gender:F
Credentials:RDN/LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 SOUTH STREET
Mailing Address - Street 2:MEDICAL COMMONS ONE SUITE 300
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601
Mailing Address - Country:US
Mailing Address - Phone:724-850-3142
Mailing Address - Fax:724-850-3143
Practice Address - Street 1:530 SOUTH STREET
Practice Address - Street 2:MEDICAL COMMONS ONE SUITE 300
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601
Practice Address - Country:US
Practice Address - Phone:724-850-3142
Practice Address - Fax:724-850-3143
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86210696133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered