Individual
JESSICA MIKITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4160 JOHN R ST STE 615, DETROIT, MI 48201-2022
(313) 745-4195
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
024089-01
NY
363A00000X
Physician Assistant
Primary
5601012966
MI
Other
Enumeration date
10/22/2019
Last updated
06/03/2025
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