Individual
DEIRDRE TARA TRACEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17120 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1661
(313) 886-3300
Mailing address
17120 KERCHEVAL AVE, GROSSE POINTE, MI 48230-1661
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704303811
MI
Other
Enumeration date
12/03/2019
Last updated
03/24/2025
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