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General NPI Number Information
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NPI Number | 1013808948
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Entity Type | Individual
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Provider Name | KERVENS GERMAIN-PHILISTIN
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Gender | Male
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Dates
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Enumeration Date | 07/10/2025
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 4750 COLLEGIATE DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-1000
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Country | US
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Telephone | 850-872-4750
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Fax |
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Provider Business Mailing Address
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Address Line | 200 NE 1ST AVE APT 920
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City | POMPANO BEACH
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State | FL
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Zip | 33060-6654
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 9473183
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License Number State | FL
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