Individual
MRS. KATELYN MARIE VANDERMAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN, FNP-BC, NP-C
Contact information
Practice address
1850 GATEWAY DR STE 201, SYCAMORE, IL 60178-3192
(815) 766-7021
(815) 758-5690
Mailing address
1850 GATEWAY DR STE 201, SYCAMORE, IL 60178-3192
(815) 766-7021
(815) 758-5690
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041-390433
IL
363L00000X
Nurse Practitioner
Primary
209013007
IL
363LA2100X
Acute Care Nurse Practitioner
209013007
IL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
209013007
IL
Other
Enumeration date
07/20/2015
Last updated
07/28/2023
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