Individual
BRENDA D JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN ACNP-BC
Contact information
Practice address
600 E TAYLOR ST, SUITE 3011, SHERMAN, TX 75090-2881
(903) 893-5177
(903) 813-0210
Mailing address
PO BOX 2432, SHERMAN, TX 75091-2432
(903) 893-5177
(903) 813-0210
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
257405
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1744534-01
—
TX
01
—
8N7563
BCBS
TX
01
—
P00264932
RR MEDICARE
TX
Enumeration date
06/16/2006
Last updated
01/07/2022
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