Provider Demographics
NPI:1780564096
Name:J & A FAMILY MEDICINE, LLC
Entity type:Organization
Organization Name:J & A FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KROSS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNP
Authorized Official - Phone:918-327-0045
Mailing Address - Street 1:1912 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-3001
Mailing Address - Country:US
Mailing Address - Phone:918-327-0045
Mailing Address - Fax:918-800-2466
Practice Address - Street 1:1912 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-3001
Practice Address - Country:US
Practice Address - Phone:918-327-0045
Practice Address - Fax:918-800-2466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-05
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty