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NPI Code Detail

MEDICARE: KETTY LEE

MEDICARE: KETTY LEE
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
1183500000XPharmacistS027667AZ

General Provider Information

NPI Number : 1891574661
Entity Type Code : Individual
Provider Name (Legal Business Name) : KETTY LEE
Provider Business Mailing Address
First Line : 2558 W TEOCALLI CT
Second Line :
City : TUCSON
State : AZ
Zip : 85745-8727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3601 S 6TH AVE
Second Line :
City : TUCSON
State : AZ
Zip : 85723-0001
Country : US
Telephone Number : 520-792-1450
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2023
Last Update Date : 03/23/2026

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Directions to “ KETTY LEE ” Practice Location

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