Jenilee Pellegrini

Individual provider Active NPI Licensed Practical Nurse · Gladstone, MI

NPI 1053226258 · NPPES record last updated Aug 14, 2026

Key facts

NPI
1053226258
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703114496 (MI)
Practice address
8496 M.5 Rd
Gladstone, MI 49837-9101
Phone
(682) 220-0866
NPI assigned
Aug 14, 2026
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse
Group: 193200000X MULTI-SPECIALTY GROUP
164W00000X 4703114496 MI Yes

Addresses

Primary practice location

8496 M.5 Rd
Gladstone, MI 49837-9101

Mailing address

8496 M.5 Rd
Gladstone, MI 49837-9101

Other providers in Gladstone, MI

All providers in Gladstone, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.