| Doctor Name: | LAURA D VANDERMARTIN |
| NPI Number: | 1902876592 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 700025 |
| Business Practice Address: | Troop Medical Clinic 724 Postal Service Loop #7499 Ft Richardson, AK - 99505 |
| Business Phone Number: | 9073840600 |
| Business Fax Number: | |
| Mailing Address: | 122a Iliamna Ave, FT RICHARDSON |
| State: | AK |
| Postal Code: | 995051011 |
| Phone Number: | 9073841408 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0400X |
| License Number: | 700025 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Case Management |
| Taxonomy Definition: | |