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MR. JACOB DEAN FULLER LPN
NPI 1720423536
Licensed Practical Nurse in Springfield, OR

Active since May 07, 2013
3333 RIVERBEND DR, SPRINGFIELD, OR 97477(877) 350-7430 Get Directions Write a Review

NPPES record last updated: May 7, 2013. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Mr. Jacob Dean Fuller Lpn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACOB DEAN FULLER LPN (NPI 1720423536) is an individual licensed practical nurse in Springfield, Oregon, licensed in Oregon (201230678LPN) and active in the NPI registry since May 2013.

NPPES Registry Identity

NPI1720423536
Entity TypeIndividualMale
Primary Taxonomy164W00000X
Provider Legal NameMR. JACOB DEAN FULLERCredential: LPN
Location Address3333 RIVERBEND DRSpringfield, OR 97477-8800
Mailing Address585 36th StSpringfield, OR 97478-5789 · (541) 513-5518
Phone(877) 350-7430
Sole ProprietorYes
Enumeration DateMay 7, 2013
✔ NPI 1720423536 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
Licenses✔ Licensed in OR · 201230678LPN✔ Licensed in WV · 28704
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
3333 RIVERBEND DR, Springfield, OR 97477
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BARBARA J VOGEL CRNA
Nurse Anesthetist, Certified Registered
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 222-3154
ALBERT R CHO D.O.
Anesthesiology
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 686-7300
AMANDA ELLEN KOONCE MD
Anesthesiology
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 681-5124
KEVIN MATTHEW ALLAN M.D.
Emergency Medicine
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 344-8757
SARAH MARGARET VAN DE VALK OT
Occupational Therapist
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 222-7300
KELLY MARIE CASEY RNC-MNN, BSN
Student in an Organized Health Care Education/Training Program
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 222-3993
MARK N BODILY MD
Anesthesiology
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 222-3154
SCOTLYN TARPLEY
Occupational Therapist
3333 RIVERBEND DR
SPRINGFIELD, OR 97477
Lane County (541) 222-7300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Fuller's NPI number?

The NPI number for Jacob Fuller is 1720423536. It was assigned to this individual provider in the NPPES registry on May 7, 2013.

Where is Jacob Fuller located?

Jacob Fuller practices at 3333 Riverbend Dr, Springfield, OR 97477. The listed phone number is (877) 350-7430.

What is Jacob Fuller's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Jacob Fuller was last updated on May 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.