Stephanie Marie Gilliland, AGPCNP-BC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704339640 Issued in MI

Practice address

2111 Woodward Ave
Detroit, MI 48201-3421

Phone

(313) 546-0900

NPI assigned

Dec 14, 2021

Last updated

Mar 26, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: stephanie.cosentino.1@27127.direct.athenahealth.com

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774483200000",
    "number": "1659030013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9714 KYLIE DR",
            "city": "BRIGHTON",
            "state": "MI",
            "postal_code": "481166824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 WOODWARD AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482013421",
            "telephone_number": "313-546-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLILAND",
        "first_name": "STEPHANIE",
        "middle_name": "MARIE",
        "credential": "AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CO",
            "license": "APN.0997154-NP",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704339640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond E Gilliam
• Dora Channel Gilliam, LPN
• Julia Gilliam
• Learah Gilliam, LBSW
• Audrey Lynn Gilliatt, LMSW
• Bethany M Gilling, FNP-BC
• Martin Ronald Gillis, DDS
• Sierra Gillis
• Roderick J Gillison, CPSS
• Brent Winston Gillum, D.O.

• Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.