| Doctor Name: | MS. KITTY KERVIN |
| NPI Number: | 1013328533 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | TAP003243 |
| Business Practice Address: | 109 Regency Pl West Monroe, LA - 712914453 |
| Business Phone Number: | 3188129999 |
| Business Fax Number: | 3183239339 |
| Mailing Address: | 130 Desiard St, Suite 355 MONROE |
| State: | LA |
| Postal Code: | 712017319 |
| Phone Number: | 3188077875 |
| Fax Number: | 3188077875 |
| NPI Enumeration Date: | 05/19/2014 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | TAP003243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |