Individual
MRS. DIANA VANDERMAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
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
Update your record
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