Healthcare Provider Details

I. General information

NPI: 1992421523
Provider Name (Legal Business Name): J&A HEALTH AND WELLNESS SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1370 N FAIRFIELD RD STE D
BEAVERCREEK OH
45432-2681
US

IV. Provider business mailing address

1370 N FAIRFIELD RD STE D
BEAVERCREEK OH
45432-2681
US

V. Phone/Fax

Practice location:
  • Phone: 937-912-5155
  • Fax: 937-912-5159
Mailing address:
  • Phone: 937-912-5155
  • Fax: 937-912-5159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JASON MARCHANT
Title or Position: PRESIDENT
Credential:
Phone: 937-912-5155