Jacob Dean Fuller, LPN
NPI 1720423536ActiveIndividual· Licensed Practical Nurse· Springfield, OR
Licensed Practical Nurse (LPN) in Springfield, Oregon, licensed in OR and WV, with an NPI issued in May 2013.
Overview
| NPI | 1720423536 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LPN |
| Sole proprietor | Yes |
| NPI issued | May 7, 2013 |
| Last updated in NPPES | May 7, 2013 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | 201230678LPN | OR |
| Licensed Practical Nurse | 164W00000X | 28704 | WV |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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