Individual provider Active NPI

Katherine Conor Aquilina, FNP-C

  • Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1821782459
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704298944 Issued in MI
Practice address
400 Mack Ave
Detroit, MI 48201-2136
Phone
(313) 448-9600
Fax
(313) 448-9978
NPI assigned
Jun 6, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704298944 MI Primary

Addresses

Primary practice location

400 Mack Ave
Detroit, MI 48201-2136

Mailing address

607 Golf Ave
Royal Oak, MI 48073-3619
Phone (248) 565-5283

Other practice location 1

9650 Wayne Rd
Romulus, MI 48174-1551
Phone (734) 942-4857

Other practice location 2

607 Golf Ave
Royal Oak, MI 48073-3619
Phone (248) 565-5283

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaquilina3677108@epic00.corewelldirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704298944MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Pediatricians CurrentSince Aug 1, 2024 Accepting new patients
University Pediatricians CurrentSince Aug 1, 2024 Accepting new patients

Locations

3901 Beaubien St
Detroit, MI 48201
Phone (313) 745-5227

3901 Beaubien St
Ste H
Detroit, MI 48201
Phone (313) 745-5437

400 Mack Ave
Detroit, MI 48201
Phone (313) 448-9006

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1686009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1821782459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 GOLF AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480733619",
            "telephone_number": "248-565-5283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MACK AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012136",
            "telephone_number": "313-448-9600",
            "fax_number": "313-448-9978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9650 Wayne Rd",
            "address_purpose": "LOCATION",
            "city": "Romulus",
            "state": "MI",
            "postal_code": "481741551",
            "country_code": "US",
            "telephone_number": "734-942-4857",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "607 Golf Ave",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480733619",
            "country_code": "US",
            "telephone_number": "248-565-5283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AQUILINA",
        "first_name": "KATHERINE",
        "middle_name": "CONOR",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-06",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704298944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaquilina3677108@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "9650 Wayne Rd",
            "city": "Romulus",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481741551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.