Individual
MISS KATI M DEREVERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1049 MAIN STREET, UNIT 2S, MOUNT DESERT, ME 04660
(207) 244-4111
(207) 244-4114
Mailing address
PO BOX 687, MOUNT DESERT, ME 04660-0687
(207) 244-4111
(207) 244-4114
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RO49940
ME
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP111084
ME
Other
Enumeration date
08/03/2011
Last updated
12/16/2014
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