Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRENT JACKSON
Active Sole ProprietorBRENT JACKSON is a Acute Care Nurse Practitioner healthcare provider located in TUTTLE, Oklahoma. NPI 1245967405 is currently active in the NPPES registry. Verify at CMS.
Acute Care Nurse Practitioner · TUTTLE, OK
Registration Details
- NPI Number
- 1245967405
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 6, 2022 (4.0623753491346 yrs)
- Last Updated
- Sep 4, 2022
- Licenses
-
96391 (OK)210172 (OK)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2377 COUNTY ROAD 1201TUTTLE, OK, 730891067Browse OK providers · Browse ZIP 73089
- Phone
- 4054123213
- Primary Specialty
-
Acute Care Nurse Practitioner
363LA2100X
- Additional Specialty
- Acute Care Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.