Active NPI
Kitty Kervin
- Psychiatric/Mental Health Nurse Practitioner
- West Monroe, LA
National Provider Identifier
1013328533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- TAP003243
- Practice address
- 109 Regency PL
West Monroe, LA 71291-4453 - Phone
- (318) 812-9999
- Fax
- (318) 323-9339
- NPI assigned
- May 19, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | TAP003243 | LA | Primary |
Addresses
Primary practice location
109 Regency PL
West Monroe, LA 71291-4453
Mailing address
130 Desiard St
Suite 355
Monroe, LA 71201-7319
Phone (318) 807-7875
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2385658 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TAP003243 | LA | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452816000000",
"number": "1013328533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DESIARD ST",
"address_2": "SUITE 355",
"city": "MONROE",
"state": "LA",
"postal_code": "712017319",
"telephone_number": "318-807-7875",
"fax_number": "318-807-7875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 REGENCY PL",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712914453",
"telephone_number": "318-812-9999",
"fax_number": "318-323-9339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERVIN",
"first_name": "KITTY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-19",
"last_updated": "2016-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "LA",
"license": "TAP003243",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2385658",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in West Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.