Individual
LORI VANDEVENTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(207) 973-7000
(207) 973-5042
Mailing address
43 WHITING HILL RD, BREWER, ME 04412-1005
(207) 973-5035
(207) 973-5042
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R047726
ME
Other
Enumeration date
09/13/2006
Last updated
03/04/2019
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