MEDICARE: TRACEY M WEATHERSPOON

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
1	374J00000X	Doula

General Provider Information

NPI Number	:	1417832643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY M WEATHERSPOON

Provider Business Mailing Address
First Line	:	727 W GRAND BLVD APT 125
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-2124
Country	:	US
Telephone Number	:	313-289-9180
Fax Number	:

Provider Business Practice Location Address
First Line	:	727 W GRAND BLVD APT 125
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48216-2124
Country	:	US
Telephone Number	:	313-289-9180
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	08/07/2025

Similar Medicare Providers

1538044623 — WILLIE MITCHELL
Practice Location Address:

727 W GRAND BLVD APT 125
DETROIT, MI
48216-2124

Practice Phone: 586-234-4053
Practice Fax:

1710857073 — TRACIE JUANITA HILL
Practice Location Address:

13868 ARLINGTON ST
DETROIT, MI
48212-2124

Practice Phone: 313-236-2070
Practice Fax:

1144181421 — MY HEART IS YOURS HOMECARE
Practice Location Address:

13868 ARLINGTON ST
DETROIT, MI
48212-2124

Practice Phone: 313-236-2070
Practice Fax:

1780546242 — IMANOL LOZANO
Practice Location Address:

2636 SAMPSON ST
DETROIT, MI
48216-1756

Practice Phone: 313-610-0138
Practice Fax:

1164384699 — VITALWORKS STAFFING AGENCY LLC
Practice Location Address:

1515 W LAFAYETTE BLVD STE 206
DETROIT, MI
48216-1926

Practice Phone: 313-829-9659
Practice Fax:

1710427000 — PAMELA TALLEY
Practice Location Address:

3627 W VERNOR HWY
DETROIT, MI
48216-1440

Practice Phone: 313-297-2975
Practice Fax:

Directions to “ TRACEY M WEATHERSPOON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.