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

MS. Courtney Tamara Jackson, NP

Individual provider Family Nurse Practitioner · NPI 1457966509

MS. Courtney Tamara Jackson, NP is a Nurse Practitioner in Valdosta, Georgia. Qualified in 2020, 6 years ago. Practices with Pruitthealth Hospice Inc, a 40-clinician group. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2020
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

407 Cowart Ave
Valdosta, GA 31602-2635
Phone: (229) 242-1187
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F09200417 (GA)

Record details

NPI number1457966509
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedSeptember 14, 2020
Last updated in NPPESSeptember 14, 2020
Certification dateSeptember 14, 2020

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Pruitthealth Hospice Inc — 40 clinicians
Accepts Medicare assignment Not indicated

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