Individual
KARYL HERITAGE MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1025 NORTHEAST GATEWAY CT, NE, CONCORD, NC 28025
(704) 920-7020
Mailing address
255 PAYNE RD, KANNAPOLIS, NC 28083-8029
(704) 938-7358
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
034284
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050798
—
NC
05
—
NAN075
—
SC
Enumeration date
05/10/2006
Last updated
07/08/2007
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