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

Jace Jackson

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1821832882

Jace Jackson is a Student in an Organized Health Care Education/Training Program in Tulsa, Oklahoma. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

1111 W 17th St
Tulsa, OK 74107-1886
Phone: (918) 582-1972
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1821832882
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJune 24, 2024
Last updated in NPPESJune 24, 2024
Certification dateJune 24, 2024
Mailing address3821 Southridge Cir Apt 4, Tahlequah, OK 74464-7944

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