Provider Demographics
NPI:1639342827
Name:TRABAND, SARAH PENNELL (RD, LD/N, CDE)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:PENNELL
Last Name:TRABAND
Suffix:
Gender:F
Credentials:RD, LD/N, CDE
Other - Prefix:MS
Other - First Name:SARAH
Other - Middle Name:BRADY
Other - Last Name:PENNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LD/N, CDE
Mailing Address - Street 1:900 UNIVERSITY BLVD N
Mailing Address - Street 2:SUITE 606
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32211-9203
Mailing Address - Country:US
Mailing Address - Phone:904-253-2351
Mailing Address - Fax:
Practice Address - Street 1:900 UNIVERSITY BLVD N
Practice Address - Street 2:SUITE 606
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32211-9203
Practice Address - Country:US
Practice Address - Phone:904-253-2351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 4568133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered