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

Jacqueline Fuller

Individual provider Licensed Practical Nurse · NPI 1689049272

Jacqueline Fuller is a Licensed Practical Nurse in Southfield, Michigan. Licensed in Michigan. Registered with an NPI since 2015.

Licensed in
MI
In the registry since
2015

Practice location Address checks out

23598 Civic Center Dr
Southfield, MI 48033-7134
Phone: (248) 469-9821
Show map & directions

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

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 4703112821 (MI)

Record details

NPI number1689049272
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 8, 2015
Last updated in NPPESDecember 8, 2015
Mailing address23598 Civic Center Dr, Southfield, MI 48033-7134

Other providers in Southfield