Jacqueline Fuller, - Licensed Practical Nurse in Southfield, MI

Jacqueline Fuller, is a Licensed Practical Nurse based in Southfield, Michigan. Jacqueline Fuller is licensed to practice in Michigan (license number 4703112821) and her current practice location is 23598 Civic Center Dr, Southfield, Michigan. She can be reached at her office (for appointments etc.) via phone at (248) 469-9821.

NPI number for Jacqueline Fuller is 1689049272 and her current mailing address is 23598 Civic Center Dr, Southfield, Michigan. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1689049272.

Contact Information

Jacqueline Fuller,
23598 Civic Center Dr,
Southfield, MI 48033-7134
(248) 469-9821
Not Available

Map and Direction




Provider's Profile

Full NameJacqueline Fuller
GenderFemale
SpecialityLicensed Practical Nurse
Location23598 Civic Center Dr, Southfield, Michigan
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1689049272
  • Provider Enumeration Date: 12/08/2015
  • Last Update Date: 12/08/2015

Medical Identifiers

Medical identifiers for Jacqueline Fuller such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1689049272NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
164W00000XLicensed Practical Nurse 4703112821 (Michigan)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacqueline Fuller is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jacqueline Fuller,
23598 Civic Center Dr,
Southfield, MI 48033-7134

Ph: (248) 469-9821
Jacqueline Fuller,
23598 Civic Center Dr,
Southfield, MI 48033-7134

Ph: (248) 469-9821

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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