Tracey, Deirdre Tara

Tracey, Deirdre Tara is an individual health care provider with primary practice located at 17120 Kercheval Ave , Grosse Pointe MI 48230-1661. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Tracey, Deirdre Tara can be contacted via phone (313) 886-3300.

Contact Information

Primary practice address
17120 Kercheval Ave Grosse Pointe MI 48230-1661
Phone: (313) 886-3300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 4704303811 Michigan

Profile Details

NPI number 1659918258
LBN Legal business name Tracey, Deirdre Tara
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 3rd, 2019
Last updated Mar 24th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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