Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brent Jackson

Individual provider Registered Nurse · NPI 1245967405

Brent Jackson is a Nurse Practitioner in Tuttle, Oklahoma. Qualified in 2022, 4 years ago. Practices with Sutter Bay Hospitals, a 69-clinician group and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
4
Licensed in
OK
In the registry since
2022
Specialties on file
2

Practice location Address checks out

2377 County Road 1201
Tuttle, OK 73089-1067
Phone: (405) 412-3213
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 210172 (OK)
Registered Nurse Taxonomy 163W00000X · Licence 96391 (OK)

Record details

NPI number1245967405
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 6, 2022
Last updated in NPPESSeptember 4, 2022
Certification dateSeptember 4, 2022
Mailing address2377 County Road 1201, Tuttle, OK 73089-1067

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Sutter Bay Hospitals — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount