Individual
MS. KITTY KERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 REGENCY PL, WEST MONROE, LA 71291-4453
(318) 812-9999
(318) 323-9339
Mailing address
130 DESIARD ST, SUITE 355, MONROE, LA 71201-7319
(318) 807-7875
(318) 807-7875
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
TAP003243
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2385658
—
LA
Enumeration date
05/19/2014
Last updated
01/15/2016
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