Organization
KONALIFE, LLC, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATI DEREVERE (OWNER)
(207) 479-2583
Entity
Organization
Contact information
Practice address
1049 MAIN ST UNIT 2S, MOUNT DESERT, ME 04660-6318
(207) 244-4111
Mailing address
PO BOX 687, MOUNT DESERT, ME 04660-0687
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/30/2026
Last updated
03/30/2026
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