Provider Demographics
NPI:1982386298
Name:KROSS, JULIETTE (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:JULIETTE
Middle Name:
Last Name:KROSS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69865 S 340 AVE
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-8324
Mailing Address - Country:US
Mailing Address - Phone:918-441-2362
Mailing Address - Fax:
Practice Address - Street 1:1520 SW 1ST ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-4839
Practice Address - Country:US
Practice Address - Phone:918-727-2790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0098212363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily