Individual
LAKEEYA K TUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1560 TURF LANE, EAST LANSING, MI 48823-6392
(517) 484-3000
(517) 484-6358
Mailing address
1560 TURF LANE, EAST LANSING, MI 48823-6392
(517) 484-3000
(517) 484-6358
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
LT014020
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0700261
PHP PROVIDER #
MI
01
—
0770041
PHP FAMILY CARE PROVIDER
MI
01
—
1006153
MCLAREN PROVIDER #
MI
05
—
4387080
—
MI
01
—
5330320
BCBS/BCN PROVIDER #
MI
01
—
P00150117
RR MEDICARE PROVIDER #
MI
Enumeration date
03/07/2006
Last updated
10/18/2019
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