Family Medicine
MCLAREN BAY REGION
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1053690438 · enumerated 2011-08-16 · record updated 2018-08-07. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: DANIELLE JACKS PORTER, CFO · (989) 894-3838
Addresses and phones
- Practice location 558 LOCKWOOD LN, MIO, MI, 48647 (989) 826-3271 Fax (989) 826-6749 Google Maps Apple Maps OpenStreetMap
- Mailing address 558 LOCKWOOD LN, PO BOX 460, MIO, MI, 48647-9387 (989) 826-3271 Fax (989) 826-6749 Google Maps Apple Maps OpenStreetMap
Specialties
- Internal Medicine 207R00000X
- Nurse Practitioner, Family 363LF0000X
- Nurse Practitioner, Pediatrics 363LP0200X
- Clinical Nurse Specialist, Gerontology 364SG0600X
- Physician Assistant 363A00000X
- Family Medicine 207Q00000X · Primary
In this directory
Locations and evidence
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Practice location
MIO, MI, 48647
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.