Provider Demographics
NPI:1750272498
Name:KERVIN, ROEMY
Entity type:Individual
Prefix:
First Name:ROEMY
Middle Name:
Last Name:KERVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 CAMPBELL CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68123-1686
Mailing Address - Country:US
Mailing Address - Phone:707-704-5227
Mailing Address - Fax:
Practice Address - Street 1:2206 LONGO DR STE 210
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:NE
Practice Address - Zip Code:68005-2977
Practice Address - Country:US
Practice Address - Phone:707-704-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician