Individual
MRS. SHANDRA MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2119 HIGHWAY 82 EAST, GREENVILLE, MS 38703
(662) 390-8992
(662) 335-7933
Mailing address
2119 HIGHWAY 82 E, GREENVILLE, MS 38703-6010
(662) 390-8992
(662) 335-7933
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R852906
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124379
—
MS
Enumeration date
03/15/2006
Last updated
10/08/2013
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