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NPI Code Detail

MEDICARE: CHRISTIANA MCMORRAN RD

MEDICARE: CHRISTIANA MCMORRAN RD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1851754758
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIANA MCMORRAN RD
Provider Business Mailing Address
First Line : 1525 S HIGLEY RD STE 104
Second Line :
City : GILBERT
State : AZ
Zip : 85296-5045
Country : US
Telephone Number : 480-757-5348
Fax Number : 844-753-5185
Provider Business Practice Location Address
First Line : 1525 S HIGLEY RD STE 104
Second Line :
City : GILBERT
State : AZ
Zip : 85296-5045
Country : US
Telephone Number : 480-757-5348
Fax Number : 844-753-5185
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2016
Last Update Date : 06/19/2025

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Directions to “ CHRISTIANA MCMORRAN RD” Practice Location

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