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

Mr. Jacob Dean Fuller, LPN

Individual provider Licensed Practical Nurse · NPI 1720423536

Mr. Jacob Dean Fuller, LPN is a Licensed Practical Nurse in Springfield, Oregon. Practices as a sole proprietor. Licensed in Oregon and West Virginia.

Licensed in
OR, WV
In the registry since
2013
Specialties on file
2
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

3333 Riverbend Dr
Springfield, OR 97477-8800
Phone: (877) 350-7430
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 201230678LPN (OR)
Licensed Practical Nurse Taxonomy 164W00000X · Licence 28704 (WV)

Record details

NPI number1720423536
Entity typeIndividual (Type 1)
GenderMale
Credentials LPN
Sole proprietorYes
NPI enumeratedMay 7, 2013
Last updated in NPPESMay 7, 2013

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