IndividualActive
Brent Jackson
NPI 1245967405 · Acute Care Nurse Practitioner · Tuttle, OK
Provider details
- NPI number
- 1245967405
- Entity type
- Individual
- Primary specialty
- Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 96391 (OK)
Mailing address
2377 County Road 1201
Tuttle, OK 73089-1067
Registry dates
- Enumerated
- 2022-08-06
- Last updated
- 2022-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.