Individual
KERIANNE FULLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD/MPH
Contact information
Practice address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525
(616) 885-5000
(616) 885-5020
Mailing address
2900 BRADFORD ST NE, GRAND RAPIDS, MI 49525-6427
(616) 885-5000
(616) 885-5020
Taxonomy
Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
Primary
4301511930
MI
Other
Enumeration date
04/16/2018
Last updated
07/14/2024
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