Provider Demographics
NPI:1568107845
Name:LUNDY, CIARA CHEYANNE (RD)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:CHEYANNE
Last Name:LUNDY
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 1:5067 E GALLOP WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-0019
Mailing Address - Country:US
Mailing Address - Phone:480-710-5278
Mailing Address - Fax:
Practice Address - Street 1:7450 E PINNACLE PEAK RD
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3435
Practice Address - Country:US
Practice Address - Phone:480-710-5278
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ86329079133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered