Individual
MRS. DIANE LYNN VANDERLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN MSN APNP C
Contact information
Practice address
725 S WEBSTER AVE STE 303, GREEN BAY, WI 54301-3539
(920) 431-5650
(920) 433-7400
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7210
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1309-33
WI
363LF0000X
Family Nurse Practitioner
4704152987
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0240937
AMERICAN NURSES CREDENTIALING CENTER
—
05
—
43830900
—
WI
Enumeration date
05/13/2006
Last updated
12/09/2022
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