Individual
MRS. DIANA VANDERMAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
22 HALEY CT, SANGERVILLE, ME 04479-3000
(207) 876-4811
(207) 695-2329
Mailing address
PO BOX 1129, GREENVILLE, ME 04441-1129
(207) 695-5215
(207) 695-2329
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R048203
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432355199
—
ME
05
—
434805099
—
ME
01
—
P00796680
TRAVELERS MEDICARE
ME
Enumeration date
05/15/2006
Last updated
08/31/2015
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