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

Keri Ann Fulkerson

Individual provider Clinical Social Worker · NPI 1770151797

Keri Ann Fulkerson is a Clinical Social Worker in Grand Rapids, Michigan. Qualified in 2007, 19 years ago. Practices with Life Support LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
19
Licensed in
MI
In the registry since
2021

Practice location Address checks out

2730 5 Mile Rd NE
Grand Rapids, MI 49525-6518
Phone: (616) 426-9159
Fax: (616) 222-0294
Show map & directions

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6801089887 (MI)

Record details

NPI number1770151797
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 15, 2021
Last updated in NPPESJune 15, 2021
Certification dateJune 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Life Support Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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