Healthcare Provider Details

I. General information

NPI: 1659320810
Provider Name (Legal Business Name): JENNIFER MARIE GILL R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

287 WOODS CT
FLINT MI
48506-5332
US

IV. Provider business mailing address

287 WOODS CT
FLINT MI
48506-5332
US

V. Phone/Fax

Practice location:
  • Phone: 810-513-9837
  • Fax: 810-250-9267
Mailing address:
  • Phone: 810-513-9837
  • Fax: 810-250-9267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704252375
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: