Brandi Jackson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP139346 Issued in TX

Practice address

910 E Houston St Ste 100
Tyler, TX 75702-8363

Phone

(903) 579-9800

Fax

(903) 579-9935

NPI assigned

Oct 19, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1356817050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 E HOUSTON ST STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028363",
            "telephone_number": "903-579-9800",
            "fax_number": "903-579-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 E HOUSTON ST STE 100",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028363",
            "telephone_number": "903-579-9800",
            "fax_number": "903-579-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "BRANDI",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP139346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390903801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlyn Jacinto, SLP
• Kimberly Estella Jacinto, DDS
• Jack Jones Hearing Centers, Inc
• John Daniel Jackman, MD
• Dominique Jackquet, LPC
• Danielle Natividad Jackson, DO
• David Nathan Jackson, PT
• Donna Lachelle Jackson
• Dorothy Louise Jackson, MD
• Idoll Tina Jackson, COTA

• Family Nurse Practitioner in Tyler, TX
• Providers in Tyler, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.