Healthcare Provider Details

I. General information

NPI: 1386318244
Provider Name (Legal Business Name): JILLIAN KATE FLOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8338 ALLEN RD
ALLEN PARK MI
48101-1399
US

IV. Provider business mailing address

2035 COMMERCE BLVD APT 215
ANN ARBOR MI
48103-4451
US

V. Phone/Fax

Practice location:
  • Phone: 313-346-9900
  • Fax:
Mailing address:
  • Phone: 734-642-6204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5601010574
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: