Provider Demographics
NPI:1447962113
Name:YESTREPSKY, JENNY GAYLE (NP)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:GAYLE
Last Name:YESTREPSKY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:GAYLE
Other - Last Name:ALTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52623 LASALLE DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2531
Mailing Address - Country:US
Mailing Address - Phone:586-292-3392
Mailing Address - Fax:
Practice Address - Street 1:36267 26 MILE RD STE 3
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48048-3253
Practice Address - Country:US
Practice Address - Phone:586-716-1371
Practice Address - Fax:586-716-4855
Is Sole Proprietor?:No
Enumeration Date:2022-12-14
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4707296995363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily