Individual
KELLY JO MCCLELLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3438 ROUTE 764, DUNCANSVILLE, PA 16635-7803
(814) 944-7000
Mailing address
14969 S EAGLE VALLEY RD, TYRONE, PA 16686-2458
(814) 414-8589
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN289417
PA
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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