Individual provider Active NPI

Jillian Flint

  • Registered Nurse
  • Grosse Pointe Farms, MI
National Provider Identifier
1104748631
Registry record updated Jul 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
4704356521 Issued in MI
Practice address
159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610
Phone
(586) 201-7040
NPI assigned
Jul 27, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 4704356521 MI Primary

Addresses

Primary practice location

159 Kercheval Ave
Grosse Pointe Farms, MI 48236-3610

Mailing address

21236 Bon Brae St
Saint Clair Shores, MI 48081-1853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1785110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1104748631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21236 BON BRAE ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 KERCHEVAL AVE",
            "city": "GROSSE POINTE FARMS",
            "state": "MI",
            "postal_code": "482363610",
            "telephone_number": "586-201-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLINT",
        "first_name": "JILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-07-27",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704356521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grosse Pointe Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.