Individual
JERRY LEE MCCLELLAN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-6261
Mailing address
PO BOX 3466, CHARLESTON, WV 25334-3466
(304) 720-8816
(904) 494-6467
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
88050
WV
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN64260
WV
Other
Enumeration date
07/16/2012
Last updated
11/04/2025
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