Healthcare Provider Details

I. General information

NPI: 1356151476
Provider Name (Legal Business Name): MPOWER PRIMARY CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4028 STATE ST. SUITE A
SAGINAW MI
48603
US

IV. Provider business mailing address

4028 STATE ST. SUITE A
SAGINAW MI
48603
US

V. Phone/Fax

Practice location:
  • Phone: 989-341-6006
  • Fax: 989-341-3426
Mailing address:
  • Phone: 989-341-6006
  • Fax: 989-341-3426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: TERI LYNN HARRISON
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 989-971-4411