Provider Demographics
NPI:1871678177
Name:MCKEE, TRICIA DEE (RPH)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:DEE
Last Name:MCKEE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7437 MELODY LN
Mailing Address - Street 2:
Mailing Address - City:JENISON
Mailing Address - State:MI
Mailing Address - Zip Code:49428-9746
Mailing Address - Country:US
Mailing Address - Phone:616-667-1954
Mailing Address - Fax:
Practice Address - Street 1:3230 EAGLE PARK DR NE
Practice Address - Street 2:SUITE 101
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-7007
Practice Address - Country:US
Practice Address - Phone:616-954-0600
Practice Address - Fax:616-954-1975
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302401225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist