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NPI Code Detail

MEDICARE: KELSEY MICHELLE LEE-TARCA DO

MEDICARE: KELSEY MICHELLE LEE-TARCA DO
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
12084P0800XPsychiatry Physician5101029051MI

General Provider Information

NPI Number : 1346980687
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY MICHELLE LEE-TARCA DO
Provider Business Mailing Address
First Line : 205 N EAST AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-1753
Country : US
Telephone Number : 517-205-4730
Fax Number :
Provider Business Practice Location Address
First Line : 205 N EAST AVE
Second Line :
City : JACKSON
State : MI
Zip : 49201-1753
Country : US
Telephone Number : 517-205-4730
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2022
Last Update Date : 06/23/2026

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Directions to “ KELSEY MICHELLE LEE-TARCA DO” Practice Location

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