Individual
LISA KERVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
100 FORE ST, PORTLAND, ME 04101-4879
(207) 808-0080
Mailing address
100 FORE ST, PORTLAND, ME 04101-4879
(207) 808-0080
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN48715
ME
Other
Enumeration date
03/06/2026
Last updated
03/06/2026
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