Healthcare Provider Details

I. General information

NPI: 1992228050
Provider Name (Legal Business Name): MERCY CHRISTIAN HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2017
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 GREENWOOD AVE
JACKSON MI
49203-3077
US

IV. Provider business mailing address

1310 GREENWOOD AVE LOWR LEVEL
JACKSON MI
49203-3077
US

V. Phone/Fax

Practice location:
  • Phone: 517-962-0123
  • Fax: 517-201-8067
Mailing address:
  • Phone: 517-962-0123
  • Fax: 517-201-8067

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateMI

VIII. Authorized Official

Name: KATHLEEN M MCCARREN
Title or Position: OFFICE MANAGER
Credential:
Phone: 734-572-8686