Individual
JILLIAN M CROSSGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSM, CPM, LDM
Contact information
Practice address
620 N 1ST ST, CARLTON, OR 97111-9642
(904) 599-9691
Mailing address
620 N 1ST ST, CARLTON, OR 97111-9642
(904) 599-9691
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10226745
OR
Other
Enumeration date
07/11/2023
Last updated
02/18/2026
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