Individual
MRS. ADRIAN BLAIR MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4114
(601) 856-2460
Mailing address
11 PROFESSIONAL PKWY, RIDGELAND, MS 39157-4114
(601) 856-2460
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R871959
MS
363LF0000X
Family Nurse Practitioner
Primary
R871959
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03052761
—
MS
Enumeration date
11/16/2011
Last updated
06/16/2023
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